HomeMy WebLinkAboutPermit Electrical 2013-6-11 Electrical Permit Application DEPARTMENT USE ONLY
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225 Fifth Street♦Springfield,OR 97477♦PH(541)726-3753♦FAX(541)726-3689
Date: /3
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
l.LOCAL ',GOVERNMENT APPROVAL _, e:` 7`.FEE,'SCHEDULE
Zoning approval verified? ❑ Yes ' ❑No ,_Number of inspections per item O Qty Cost :Total
;
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT SpdngfielaOR 97477
OREGON 541-726-3753
811-SPR2013-01242
www.springfield-or.gov 200 21ST ST permitcenter @springreld-or.gov
RECEIPT NO: 2013001197 RECORD NO:811-SPR2013-01242 DATE:06/11/2013
1ACCOUNTCODE/TRANS!CODE ,Y£�.'_ 't:''AMOUNTIDUE't';
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 19.50
Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
's PAYMENT TYPE f_'`+PAYOR �:casNieR:maowuSav C'OMMENTS ,_;if?...��f�m :�r_== AMOUNTPAIp 1 �V��,,;
Check RS ELECTRIC LLC 93.60
5313
TOTAL PAID: 93.60