HomeMy WebLinkAboutPermit Electrical 2008-6-6
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SPRINQFIELD
22~ F.fFTH\TREET . SPRINGFIELD, OR 97477 . PH:(541)726.3753 . FAX: (541)726.3689
ELECTRICAL PERMTT A PP1.ICAHON
City Job Number (' ..A:flr) JOO<..(- (;) J '-f 8~
1. LOCAl'IONOF INS1'ALLATION:
3~33R,~(~n.J W
LEGAL DESCRIPTION:
:\1~ ~'A- rDtDQo2--
JOB DESCRIPTION: I-OvJ Vot+-"'.)It.. T. <..
Lc.-.~ lu h-" .)e,t-UI'.'!-\i
Permits are non-transferable and expir/if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
CONTRACTOR INSTALLA1'lON ONL1'
Electrical Contractor
Address~()7 <~'1 51-('" :Jib
City 4/1';"'?tli Phone 54/- 72t-Cl'zoq
Supervisor License Number
<1'2.1...11 U:A
Expiration Date I D - 20nx
Constr. Contr. Number I stj .J /)0
Expiration Date ,7// tP I J-VU 1
Signature 07;lectr~ian
OWl}ers#" -:' (1 ~ ~,Q...
A~~)( \D:~
CirP~ Ph~ne
OWN~T~:1~
Mr--...
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Iuspection Request: 726-3769
Date
3.
COMPLETE FEE SCHEDULE BELOW
SCAtn~ElO
A. N,'w Residcutial- Single or Multi-Family per dwelling unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$117.00
$ 21.00
$55.00
B. Sen'iees or Feeders - Installation, Alterations or Relocation:
.--.- , "r'lli to
ATTP'T'r:' ,. r ,.' . , .
, ^ ' '..llty
200 Amp~c!l.r.l~ss:" " ".. " ' :,$ 70:00 t'
\." _ ,,"',. .'.... '-'. drt) ~p.~Lor '1-.
201 Amp!;to:400'Amps- ' ", '~\$ 8~. -'001-
'fI() n,r :......11 'JLIV.Il,.j~,U"""" h~::>
401 Ampti to 600'Amps' bt' r C"~:M nl t1~~8!(!(! bv
0090 You ,nay 0 dll -," .~.
601 Amps T8~,9.?,~1mP~enter. (Note: the tE$~~o.1lge
Over 1000~Qlls the. Oregon Utility N'$~T3~n
Reconnect Only Center IS 1-80U'~,)"-"~55.00
C. Temllor.lr)' SCl'vices 01" Feeders
Installation, Alteration or Relocation
200 Amps or less $ 55.00
201 Amps to 400 Amps $ 76.00
401 t~n~~Amps $110.00
Over?i.QO~,MIT0801~blts~~,I~1I J~oWE WORK
D. BrM.EliHflru.i'@ UNDER THIS PERMIT IS NOT
("!'\r'~~Al:Nr~E~ ~R IS ABANDONED FOR
New l\lteration 'Or- x rniefbl'er Panel
One 2&!~ii' 80 DA I. $ 48.00
Each Additional Circuit or with
Service or Feeder Permit $ 4.00
E. Miscellaneous (Service/feeder not included) -Each Installation
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
Limited EnergylResidential $ 28.00
Limited Energy/Commercial / $ 50.00 ,or
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
4. SUBT01'AL OFABOVE
t--
<
'1 ,'v
12% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
~ 3~~
Shared Drive(T:)/Building Fonns/Electrical Permit Application I-OS.doc
225.Fifth Street
Springfield, Oregon 97477
541-726~375!i\Phone
. 8PRINGlF1aD
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~
IIa.: ~."" _:
CiJiiif Springfield Official Receipt
.opment Services Department
Public Works Department
Job/Journal Number
COM2004-0 1488
COM2004.0 1488
COM2004-01488
COM2004-01488
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
3200800000000000377
Date: 06/04/2008
Description
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Paid By
NATIONAL NETWORK
Item Total:
(.:heck Number Authorization
Received By Batch Number Number How Received
njm 027026 In Person
Payment Total:
Page I of I
2:39:02PM
Amount Due
2.50
6.00
5.00
50.00
$63.50
Amount Paid
$63.50
$63.50
6/4/2008