HomeMy WebLinkAboutPermit Electrical 2000-1-28
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DATE:JAN 28 2000
AMT RECD:2 $ 47.30
CHANGE:
CASHIER:Q'03
"'.ECTRICAL PERMIT APPLICATION
The, following project as submitted has the following
zonmg, and does not require specific land use
,_ approval.
Zoning L t:::>1L-
9flm /- ~ - tH)
JI2.6toaitllPSignature q<; .J
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCAT]ON OF/INSTALLATION
11''L ~{i..Ltt:.k .or-
LEGAL DESCRI?TION
/7/J 3> Z'! ~ '< ~ J.)/Jl')
() JOB IPESqu.PT+ ION f J ,
I"'-e.~ k, J......-.., <f, 4.'-''-<d'7 .
Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days,
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor Ro...u...60lJ tJedt.:..c.
Address A,J-J 6e WL.... he~V''-/ Ck
City FcJ( erL Phone 937-37"'{'
Supervisor License Number < q. <;'.J......~
Expiration Dat~O-~OO(
City Job Number
rJO "oolElJ -(J(
3. COMPLETE FEE SCHEDULE BELOY
A. Ne~ Residential-Single or
Multi-Family per d~elling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to' 1000 amps
Over 1000 amps/volts
Reconnect Only
uni t.
Cost
$ 85.00
$ 15.00
,$ 40.00
Sum
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
New, Alteration or Extension Per Panel
One Circui t I $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit ~ $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ~~,~
7% State Surcharge :<:',01'
3% Administrative Fee 1,2..'7
TOTAL d. 7 ;{1J
7 ( ,
Expiration Date
Signature Of~~g ~e~trician
t::, O~u'- (=at T~
Address 24-( '--.. I<-<>-"'-.c...h... Dr-
Ci ty 5._ P , Phone 72./~ -<) 4f-, 2
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
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DATE:
RECEIPT #:
RECEIVED BY:
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
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~' "; ( . I!~' REC'EIPT ~~;'~ICAl~ ritCEIPT
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CITY OF SPRINGFIELD
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541)726-3753
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HAPPY NEW YEAR!!!!!!!!
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REG-RECEIPT:Ol-0000405 C:JAN 28 2000
CASHIER 10:003 4:01 pm A:JAN 2B 2000
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1004 ELECTRICAL PERMIT $43.00
JOB~:00-00143-01
1099 STATE SURCHARGE(7%) $3,01
J08~:00-00143-01
1098 ADMIN FEE(3%) $1.29
JDB~:00-00143-01
TOTAL DUE $47,30
RECEIVED FROM:
RAINBOE ELECTRIC INC
CHECK: $47.30
TOTAL TENDERED $47.30
CHANGE DUE $0.00
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*Pay Name :RAINBOE ELECTRIC INC
*Mail Addr :42168 WINBERRY CREEK RD
*Cty/St/Z :FALL CREEK OR 97438
*Site Addr :2412 RANCH ORIVE
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THANK YOU!!!!!!
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