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Home My WebLink AboutPermit Electrical 2006-4-26 (2) ",~",,,,,,,,,''''L(.'~~, &l!~~il~~,.;f,;i~l~';~~I".,*,:;~:! _N ._.....;;'l.,.~__.....~.t'...'"".,.,..,..+.:,.'--':,,,..*I'".,.,.ti_l.-...~.,1;_}f.~~~~......_:-~~.j:..~~ .~."~'""'..~........_......>-;.;.~~>,';!:l,~l:J:.":,,.,..~~~%;:;~~:., "......,.-...:..."'-......,.,.- .. Z25 ~ U'.n STREET 0 SPRINGFIELD, OR 'Y/477 0 PH:(541)726-3753 0 FAX: (54I)7Z6-3689 ELECTRICAL PERlUlT APPUCATlON City Job Nwnber CO V\/\ 'Z-O 0 c.f - 0 I L{ g- r Date 4126~6 SPRtNGoFI5LO ~.-~-;--:. ~Vi' 1.1.0t"d1TlONOF LVSTALLA110N 3333 Game Farm Road 3. COMPLETE FEE SCHEDVLE BEI.OW LEGAL DESCRIPTION )70J2200 JOB DESCRIPTION DC 702. A. N~w Rt'sidenthll- Singh.' or J\'lulti~F;lmil)' ~r u\\....lling lUlit. Service Included Permits are Don-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1.. ',CONTR.'\CTOR INSTALLATlONONU' 1000 sq. ft or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular DweI1ing Service or Feeder $106.00 RiverBend Hospital DOC $19.00 $50.00 B. Sen-kl'S or Fccdcrs - Instnllatinn. Altcratinn!l or RcloC'dtion: Electrical Contractor L.H. Morris Electric. Inc. City Springfield Phone 541-74Hl811 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVoIts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Address 483 Shelley Street Supervisor License Nwnber 3OO6S C. Tcmpnnu')' SclTkc~ or Fc~"i1cri Expiration Date 618~7 Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits $ 50.00 $ 69.00 $100.00 Expiration Date 10/1/07 Constr. Contr. Number 1838 .:?~Q:tric:_ f" ~ tl New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Sezvice or Feeder Permit $ 43.00 $ 3.00 Owners Name PeaceHealth Address 1255 Hilvard Street E. i\lisccllancous (Scl"'i'icrifccdcr nut includNI) -Each "lnshlUotion City ~ unAnA Phone b"00.-t-~ <?'G5 Pwnp or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Conunercial 200 $ 45.00 S9llOO,OO Minimum Electric Penuit Inspection Fee is $45.00 + Surcbarges OWNER INSTALLATION Tbe inslallation is being made on property I own which is not intended for sale, lease or rent. Inspection Request: 7Z6-3769 4. SVBTOT.4.L OF ABOlT $9000,00 8% State Surcharge $720.00 10% Administrative Fee $900.00 TOTAL $10,620.00 Owners Signature: Shared Drive(T:)'Buildina FDt'm5lElcctrical Permit Application l-06.doc . City of Springfield Pennit Fees-Riverbend Hospital DDC A. Residential Per Unit Service included: 1000 sq It or less Each additional 500 sq It or portion thereof Each Manufd. Home or Modular DwellinQ Service or Feeder B. Service or Feeders Installation, Alterations, or Relocation 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 ame.s to 1000 amps Over 1000 amps Reconnect only C. Temporary Service or Feeders Installation, Alterations, or Relocation 200 amps or less 201 amps to 400 amps 401 amps to 600 amps Over 600 amps to 1000 amps see B above D. Branch Circuits New, Alteration, or Extension Per Panel One circuit Each additional circuit or with service or feeder permit E. Miscellaneous (Service or Feeder not included) Each pump or irriQation circuit Each siQn or outline lighting Limited EnerQy/Res Limited Energy/Comm Minimum Inspection Fee SUBTOTAL OF ABOVE 8% State Surcharge (.08 X Total Above) 10% Administrative Fee (.1 X Total Above) TOTAL ~ . Items Cost (ea.) Sum o $106.00 $0.00 o $19.00 $0.00 o $50.00 $0.00 o $63.00 o $75.00 o $125.00 o $163.00 o $375.00 o $50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 o $50.00 o $69.00 o $100.00 o $0.00 $0.00 $0.00 $0.00 $0.00 0 $43.00 $0.00 0 $3.00 $0.00 0 $50.00 $0.00 0 $50.00 $0.00 0 $25.00 $0.00 200 $45.00 $9,000.00 0 $45.00 $0.00 $9,000.00 $720.00 $900.00 $10,620.00 . ..~ Wit ns Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0 1488 COM2004-01488 COM2004-01488 COM2004-01488 Payments: Type of Payment Check CreditCard Job/Journal Number COM2004-0 1488 COM2004-0 I 488 COM2004-0 1488 COM2004-0 1488 Payments: Type of Payment Check CreditCard cReceintl RECEIPT #: 1200600000000000678 Description Low Voltage - Commercial Indus + 8% State Surcharge + 10% Administrative Fee Plan Review Electrical (25%) Paid By PEACE HEALTH PEACE HEALTH Received By lkw lkw Description Low Voltage - Commercial Indus + 8% State Surcharge + 10% Administrative Fee Plan Review Electrical (25%) (;heck Number Batch Number 00256593 7004668 <.;& of Springfield Official Receipt .Iopment Services Department Public Works Department Date: 05/18/2006 Item Total: Authorization Number How Received I n Person 071769 In Person Payment Total: Item Total: L:heck Number Authorization Received By Batch Number Number How Received Paid By PEACE HEALTH PEACE HEALTH Ikw Ikw Page I of I 00256593 7004668 In Person 071769 In Person Payment Total: I :54:39PM Amount Due 9,000.00 720.00 900.00 2,250.00 $12,1170.00 Amount Paid $ I 0,620.00 $2,250.00 $12,1170.00 Amount Due 9,000.00 720.00 900.00 2,250.00 $12,870.00 Amount Paid $10,620,00 $2,250.00 $12,1170.00 5/1 8/2006