HomeMy WebLinkAboutPermit Electrical 2006-4-12
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225 FUll! STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERNIIT APPL1~ATION B
City Job Number Co t--t\. '""LOa S ~ \. ~ S Date 4-- \ '2..- <!) ro
1. LOCATJONOFINSTALL.4.TION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
C. LA..4>
,
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
N ~ I~ J
2.
COi''''TRACTOR 1NST.4J.L4.TJON ONLY
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3. COMPU::rr FEE SCffED[TI,f; ImLOll'
A. New Residential -Single fJrMuUi-FamHy per dwemn~ unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling SeIVice or
Feeder
$106.00
$ 19.00
$50.00
B. &n'kes or Feeders - installation, Alterations orRcforai'ion:
Electrical Contractor C I, & IL fl.V C : t y (;/ G ",1q{.,' L 200 Amps or less 6 $ 63. 00 '37~
, 201 Amps to 400 Amps "" $ 75.00 ~",D
Address /,~ q b '12,., eol S1 SC 401 Amps to 600 Amps $125.00 r...
601 Amps to 1000 Amps 3 $163.00 48'1
City 5Pr/&:W1 Phone SO 3 - S 10-1 'iul.( Over 1000 AmpsIVol18 3Q $375.00 J.!j I ?. S'D
Reconnect Only $ 50.00
Phone 503- '5 u~- ~ I?L../ Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial S $ 45.00 :2.1,S"
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
Supervisor License Number 3 L{ ~ fa S
Expiration Date , 0 - 0"')
Constr. Contr. Number q ( b ~ B
'30762.0
7-1,-(})k.
Expiration Date 7 - , - {J 7
~::u3n~ ~
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OLners Name S &>. C. ~ If J U E t+- ~ ,.. 111 " (.} ; C A (
Address 3. ~ ~ s q A "" ~ . {" ^" n.. YY\ 11.. ..{
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City5f;)~\'11"i 6- \~
OWNER INSTALLATION
The installation is being made on prvr-,tf I own which
is not intended for sale, lease or rent
Owners Signature:
Inspection Request: 726-3769
C. Temporary Senkes or Feeders
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
$ 50.00
$ 69.00
$100.00
Over 600 Amps o~ 1000 Volts see "B" above.
D. Branch Cinui1ii
New Alteration or Extension Per Panel "-
One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Permit t-1-~ $ 3.00 '3 97
E. Misc"Uancnus (Scrdcclfeeucr not ind\ldcd)-Each 11lst311utinn
4. S1[IRTOT.1\L OF ABOVE
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l ~'11 '1"'/
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/q 4 q I . ~
8% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding FonnslElectrical Permit Application l-06.doc
225 Fifth Street
SpringfieH1, Oregon 97477
541-726-3759 Phone
RECEIPT #:
Job/Journal Number Description
COM2006-00005 *Electrical Permit
Payments:
Type of Payment
Check
Paid By
CHERRY CITY ELECTRIC
cReceintJ
Ci~jf Springfield Official Receipt
D~\<v~pment Services Department
Public Works Department
2200600000000000464
Date: 04/13/2006
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Ikw
032867
In Person
Payment Total:
Page I of 1
2:38:47PM
Amount Due
19,491.24
$19,491.24
Amount Paid
$19,491.24
$19,491.24
4/13/2006