HomeMy WebLinkAboutPermit Electrical 2008-1-15 (2)
CITY OF SPRINt. .ELD, OREGON
B~
ZON L D2.
INfI1ALS ----Y.M
DATE 1-1<; -oV
SOURCE -h.!."'-
,
22S FIYl1I STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRI~I'ERMIT APPUCA!lON
.CiiyJObNumber CbIYl21f7J1-nl.L:,5<;
I. I LOCATION OF INSTALLATION: I
/1'-1 b ::;' "'6/'/ /"W 1"';)
LEGAL DESCRIPTI6N:
/703 -;;;n 2~ 0 ;;nc)..-
JOB DESCRIPTION:
BIffItlC.07J u (/2Nn~ a/
Permits are non-transferable and expire if work is
notstarted witbin 180 days of issuance or if work is
Suspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY I
Electrical Contractor k S' E/ r' ",t;;u /~-
Address {J (). '!3".rv .;;2..1;/9?3
,
Ciiy /2/ r.,,'/>A.; Phone 6/6 ~G ::JJ.b
/
Supervisor License Number :5 V'9 7 S
. Expiration Date I d // //0
Constr, Contr, Number 1o? g> 7"
Expiration Date
10 - lu-OY
~''':":7M
OwnersName .IDtl()y" L ./.Ir1, joH7J
Address I/L/h Se;Y./d/A .
Ciiy ::Or. ^ff t/..o Phone 6 'J9-~7JO )m;r
OWNER INSTALLATION
The installation is being made on property I owo which
is not intended for sale, lease or rent.
Owners Signature:
.
Inspection Request: 726-3769
COM 200 7-CJISSJ
Date
/-- / 5-0%
3. I COMPLETE FEE SCHEDULE BELOW ~
~r
A. I New Residential- Single or Multi-Family per dwelling unil
Service Included
1000 sq, ft, or less
Each additional 500 sq, ft. or
portion thereof
$117,00
$21.00
Each Maoufuct'd Home or
Modular Dwelling Service or
Feeder
$55,00
B. I Services or Feeders - Installation, Alterations or .Relocation:
200 Amps or less $ 70,00
20 I Amps to 400 Amps $ 83,00
401 Amps to 600 Amps $138,00
601 Amps to 1000 Amps $180,00
Over 1000 AmPs/XP!~NTION' $413,00
Reconnect Only follow rules . dOl ~yon law $:55JOO,S VOl' In
Nnfifirorttir.n ~~ 'l~/'Jlt:~ oy The OreQon Utility
C. I Temporary Services.,!r F:\'!l"'" --: .'''' ::,'i f.Jrth
UUtlO 'yj . --~.. ......r\ll \:1;..1'::;.UU1-
, ^,:,_~o~ may ob~aln copies of the rules b
Installation, A1temtloo or.lRelllCll.tll>n;Nole' the tel h Y
number for th 0 . ep one
200 Amps or less e, regon UtiS9HlQjficati~R
201 Amps to 400 Amps Center IS '-tlUU-332s2i6109. .
401 Amps to 600 Amps $110.00
Over 600 Amps or 1000 Volts see "B" above,
D. I Brancb Circuits
New Alteration or Extension Perll'iln'i1pd ^~~~~\ '
One Circuit ONlJalJ S\ 'dp 0$ !l8.00. ,
Each Additiooal::tfu\:b1f~~tlsIH1. \:I3UN\ll\j~I~\" Slk
Service or 1'\5~e'9tcl1lil\ldj dX3 ""'j~~~ !\tlf.oo,d .
';11 'lU\ -113\:11 ,. :~~1.1.\j..
E. I Miscellal~lt. (S;;"'icelfeeder not included) -Each Installation I
Pump or irrigation $ 55,00
Sign/Outline Lighting $ 55.00
Limited EnergylResidential $ 28,00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Inspection Fee is 550.00 + Surcharges
4. I SUBTOTAL OF ABOVE I 5~. OV
12% State Surcharge 5. z....cJ
10% Administrative Fee <0. :;> Y
5% Technology Fee d ('. I)
U~- oy
TOTAL
Slw<d Drive(T:)lBuilding FonnsIElectrica1 Penni. Applicalion 1-ll8.doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
. "~Q~~. '
lJA.. J ..
~
c.r Springfield Official Receipt
D opment Services Department
Publie Works Department
Job/Journal Number
COM2007-0 1553
COM2007-01553
COM2007-0 1553
COM2007-0 1553
COM2007-0 1553
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Date: 01/15/2008
1200800000000000038
Description
+ 12% State Surcharge
+ 10% Administrative Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
Paid By
KS ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
5636
In Person
Payment Total:
Page I of I
9:59:58AM
Amount Due
6.24
5.20
48.00
4.00
2.60
$66.04
Amount Paid
$66.04
$66,04
1115/2008