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HomeMy WebLinkAboutPermit Electrical 2011-5-20 08/19/10 THU 16:15 FAX 541726~689 CITY OF SPRINGFIELD 1aI001 225 Fifth StTCcl.SpriD~n<ld, OR 97417. PH(S4I)726.J75HFAX(541)7U.J689 BPRffr(GFl6LD -e:::;;::''":;.;~ bE'< ~~ tt ~ ~.,.;~"...~ J:i,~~~,:"Y~/.'.,. !.<:,~,-' ";,:.~',r.:,: ,:;:;~ .....,~ ;f2a~;~"1V" . . DEPARTMEN1' USE ONLY Electrical Permit A Pennitno.: ~ 1 - Dale:5 -7--8 - 1-1- Tbls permit i. issued under OAR 918-309-0000. Permits are nontransferable. Permits expire If work Is not started within 180 days of issoanee or if work is suspended for 180 day.. : , '(QCAt GOVERNMENT 'APPROVAL:" .... :j:' , ,.;.:.::.;:.:t."'.?i;'~',j,;\<-Fe:'-'$CflEQUtE;::..r,',; ///~:;:{ :f(;:j:': ~t';~:~.~: ':\' , Zoning approval verified? DYes DNo .~umber' ofJflsp~<ti~~~per itiim(} . -.. ~, : Cost.'. T'OtaI " ". - '.:CA1E~ORYt:.o'f :co~siRUCi10N'::/ " . ," :...... "::., ,',. . ..-.'..... '." -...ea. . -'~I\st : -- l-s:1te.ldential I 0 OovcmmeDl I 0 Commercial R..identlal, per unit, ....vieeineluded: 1;;:,'F:_j,':JOB(':$JTEi'INf()RNlil<TIQN;AWDFtiOtAtfONli~';'/.': ,:' 1,000 sq. ll. or less (4) $134.00 $ , '., ~. ... , .. " . '-. - . , '.., ., "..,'. Each additional $00 sq. ft_ or portion Job site address: 3,9,"f'::r RLctrLA-AP !hereof $ 25.00 $ City: State: I ZlPLi ~ 'i Limited energy (2) $ 32.00 $ Reference: 'Q PfZ-- e-6 ~ 1 Taxlot.:C ~~ \0 Each manufac:tmcd home or modular $ 53.00 $ . 'DESCRiPTION- OF W[)RI("- ..... '-.\ -, dwell inll .ervlee or feWer (2) 2- / /'All-_7 -.... ServiCd or feeders: Installation. czltera/itm. relocation 200 amp. or los. (2) $ 81.00 S PROPERTY OWNER 20 I It> 400 amp. (2) $ 95.00 $ Name: I r;::=LI r;:::;r j r::= L1 40110 600 omps (2) $1611,00 $ Address: ---; ~4-f., -::;--- 'iJul'1k) 60110 1.000 amp. (2) $205.00 $ City: Stale: I ZIP: C[ --rq--..;- f- Over 1,000 amp. or volts (2) $469.00 $ Pbone:S'''ft 7fb -;..., Pax: - - Reeonnool ODi)' (2) $ 83_00 S B-mai!: Temporary servi... or foode,., Irula/l4tio alteration., ,.,Iocation This installation is being made on residential or fium ~perty 200 amp. or I..., (2) $ 63.00 $ OWlled by me or a member of my immediate family. is 201 to 400 arnp. (2) $ 87.00 $ prope~ is nol intended for sale, exchange, laaso, or rent. OAR 40110 600 amp. (2) 479.54 (I) and 479.560(1). . $126.00 $ Signature: Over 600 amp. or 1,000 vollS, see S01'Ii..s r feede,. oection above _CONTRACTOR . INSTALLATION Branth clrc:ultfll new. alteration, ut~nston Cfr pan.~1 Business name: ^O W \'e\',,,o\A<;' el irk-{ ~ C. .. Foe for ~ranch circuits with purt:hose of .~rvlce or feeder fe.; Address: 7-0s. Wi-SOl,,- 2"'dI. A.\le Eech braneh circuli I $ 6.00 $ City: .p Ur.'J1!1f? State: O~ I ZlP:a, 1UO? b. Fee for branch circuits wilhoul purch... f B. service OT fc:-oder fee: phone&J\-?:Hh IZo../ I FaxW\-?:l--I~ L(~Q Fi"'l branch circuit (2) $ 55_00 t::b: r;, E-maJl: _ Eech additl<>nal branch circult \ $ 6.00 $ (p ,c- CCB license no.: \ISLiC{Zl \ BCD Hoenseno.: U-l(\ Miseelloneou. r...: seMllce or fe.der noli cl """<I Sirnlna suoervisor'. license no.: 5>404 .s, Eneh pump or iniflll1lon circle (2) $ 53.00- S Print name of silming .upervisor: ,- ~ 0e \""'-i '\e" ,-.;. kEneh,1 me lighting (2) $ 63.00 $ Signature of signing superviso~ ~ _____I-- f-s[gnat circuit Dr alimitcd-cnergy p""e., $ 63.00 $ 'l< eller.tion, or exten,ion (2) L-- Eaeh odditionoliD'pection: (I) $611.00 $ 5''L'b'\\~ ".?'of4r,,:&!:,,:.:iW:;;;;:~l!i.:1CJli~t',~ :.-i;:':,':.if,:."S:,::, (A) Entcr subtotal of above fee. $LD\.~ ~~ (MiDimum Permit F..S58.00) (B) En\A:or I~% surcharge (_12 x [A]) $ r .'}{) ~~ (C) Technology Fee (5% orlA}) s _ot: TOTAL fee. and su'charges (A th,ou hC): $ m.1 ) 44O--2584--J (9108/COM) ~~ ~.\9'\\ rt Vb'] '2.D\\'" BCV1