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HomeMy WebLinkAboutPermit Electrical 2003-12-18 . " '} . " ". <:<"... _~,,...;.. '^';'~~'~" .",'t, . ,./ ...... ..~<,. " .. . ...... :' .<".},.': . CITYOFSL.dINGEIECD'OREGON . 1 .; . (l'~.""__".'~J:;'::' :'~~!."...".: ','... . ;"..'," .'::". .;.... ...~.. "-,~.., .'. ect as submitted has the following not require specific land use 225 HI! In STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: ~~~i5~16-3689 ELECTRICALPERMlT APPliCATION C\. ,Zoning, City Job Number (0wi1...(,(J"O(n~~ Date 1)-'5k-cfJ:> Date Authorized Signature [W0ffioMoFiiNSt,MMrfi'o&,tlj!llI.-.4ll r,.-",'-' '."'^ "'_d', ,.",-. ~' 'if{~"'~,~--':~ 1. , """,,~""<_""__' __...-_",rli',;~\"'\ 3. i!if2J!.~ng;,r,-€if..g~c;,!i-!fQ~:P.&,I,-QW~iSi;d~"j;;~~ bO,),1 '/l.JmlC€ fL, LEGAL DESCRIPTION /W20! lei /JYJ/f/ JOB DESCRIPTION ('~r L ~ - b-- -j\fb PermitS are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days,' . rC::-..v"...l: ..1.....>1.....""'-"- -..-. ...4~...' .....:. "\.....,,: .;!:to" ",,-P'< .~~--~;.;.."'" 1 "CONTR:ACTOR-INSTALEATIQN.ONEY 2. ~ .~...".r.~'~~ ,V'~"""_1. ~., ~~,',."":rT.i.(,.-_...-..r-_---.. Electrical Contractor t A SrS I{)~ € [tU/(J( Address 38"lS'3 !305C,46{ G~;/Vf City sPyG{J Phone 7Y/-IY11 Supervisor License Number L/ 7;l 7 S Expiration Date ) () -0 1- 0 t.j Constr, Contr, Number J I 7 7 7 () Expiration Date I ()- 0 J - 0 <t Signature of Supervising Electrician RJl}J.1 v' Kv~ .J Owners Name lJ..A'rIJEN EI-JTEKPlo.SfS Address .;;1611 5\'1 GLACIER t>L '#-110 City RE:()mONo Phone 736- /17;). ; -,~. -' OWNER INSTALLATION The installation is being made on p,rope~ I oW)! w~ich is not intended for sale, leas~ or rent. ' I ' ",. Owners Signature: ." 11:' Inspection Request: 726-3769 ~.. :Jd L-b (Z. '\2-1~..{)' , oK v.J A ~N-&~R' -; ~d",~,;;r""'l)'!{S~:;"'~lc;~":~?'I~l '''F''''~?1!ll1'1~'Yd.~llf,ililt.1,:,~",']I .. t:2L~~:.....~~~.sn!~~;~: ,~IL ~:P!~l.~~S~~~~J: ,p~!,- .."!.v.~ _~~~~I!:i;~ Service Included 1000 sq, ft, or less Each additional 500 sq. ft, or portion thereof Each Manufac!' d Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50,00 B. ~Sef~iceS~~~F~~de~~~'~I~:Hlli~ ti~~;'?Xi~i~ ti6fl~~9~i"~'Ri}()'"c1Hij"1':~;~' 1 ~.l"..:JN.'',;--.,." ...-t-~",",., '-"t -~~.." "'I:".,;.'f"~'<.,) """!\:'"\trj~.r..:n-.'t"':-:I,~~~,-1" 200 Amps or less. 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only $ 63,00 $ 75,00 $125.00 $163,00 $375.00 S 50,00 . c. P.~ifem'p'-ohi'iv;S~}:'t~c~."ofJ!eeder.s~,,~:'-t ~~~ ~~Q._&'';'''~'''-"''''::i~_., ',' -"',- ,-' ','. ': ....., .~~, '~d.' ,.:. :",", ,e. ~': I &'iH"~',<<.~,.t',~.;:l,_...L..:" ;J, Installation, Alteration or Relocation, 200 Amps or less 201 Amps to 400 Amps 401 Ainps to 600 Amps S 50,00 $ 69,00 SIOO,OO Over 600 Amps or 1000 Volts see ",8" above, D ~B,--<~-,~;..F'h-:J:;"':~-""'j.";''''' . ",,"-,' ~,,;:-'~';,';. (~'':,'-'.i'':, ,tI~t'::'1 . ~!l,!1,C...f':=-!J:"SI.!~':' '''. ,A J'.iR>. '.., ,,~..,.~ ..;,:-.t};..:~~,,,,:,>--,, New Alteration or Extension Per Panel One Circuit $ 43,00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 E. lt~i~;!f~~~e~~;'iscet>i~~1fe~Mf' n';t)Jitti!i1~d),;'E.cti'ri~t~~~Ji,~1 Pump orirrigation:' _~ Ir~50,()(llnRK '\I~' ....-. l.. ~1m-vv SignlOutl\'i115i~.!\illl\\1 ~HAll t"rln ~ ;:f1~v~q,q~ ~lnT L' 't dE _,,;0 ~"a-""l,t,mER I tll;) r S,2,5.ooR lID! e , R~"lm~~,-enu.... , "-3N1:U I'\J Limited Ese!gy;I,~Q.idfn~iMR IS /-101'11"-' , $ 45,00 Minimum Electi-ii!Pe1-\\nt~~~fc~i~lq..~e i~1 Surcharges ~j;;-:t:tvr''':'7J1.3!:. ''l.~, :4~' ..rvt_,_.:. --';", _'. h"'~ 7, ~";,i' 4; ,SVBTOTAE'OF.ABOVE~ .,., ,. 0-" ,:" ". --- w.-......"'I'-.:c,_..,._ -',.' "''',..._;_,,,,..,,.., '; ,;l...~ ,tr".",.'.'" ,'....-... L\ C , _ ""___" __ '-" ',.~- ,,'_ ," 1>1''-' .,.-:, __...._~.._.':...:.: ~ ~ I') \...\ <)'0 ~ 2. ~ <) 7% State Surcharge I!J% Administrative Fee TOTAL Shared Drive(T:)lBuilding FonnslElectrical Permit Applicntion 1-03.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00726 COM2003-00726 COM2003-00726 Payments: Type of Payment CreditCard ~~"'CC'5'~. .' ' ",. Ittr-, , ,. .' , .,.-...,....,-*"'-. - .-. - Receipt #: 1200200000000002622 Description + 7% State Surcharge + 10% Administrative Fee Other Electrical Permit Paid By ROGER D KING Check Number Received By Batch Number Authorization Number dIm 000251 017864 City of Springfield Official Receipt Development Services Department Public Works Department Date: 12/17/2003 11:08:S7AM Amount Paid 3,15 4.50 45,00 SS2.6S ~ r.. .: Item Total: How Received In Person Payment Total: Amount Paid $52,65 SS2.6S . .