HomeMy WebLinkAboutPermit Electrical 2018-09-27CITY OF SPRINGFIELD, OREGON
Electrical Permit lication
225 Fifth Streett Springfield, OR 97477 t PH(54r)726-3753i FAX(541)726-3689
DEPARTMENT USE ONLY
Permit no.: l0 -n 27O I
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This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissuance or ifwork is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoningapproval verified? E Yes E No
CATEGORY OF CONSTRUCTION
D Residential D Govemment E Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: l0CA L J t
City: \/nvq h'r,1,{State: olh nPt q?\r+
Reference:Taxlot.
DESCRIPTION OF WORK
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PROPERTY OWNER
Name:\
Address: W7fo
City:State: o 1?.zrP: 7 7127
Phone Fax:
E-mail
This installation is being made on residential or farm prope(v
owned by me or a member of my immediate family. This
properf,v is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560( I ).
Signature:
CONTRAGTOR INSTALLATION
Business name:LC
Address:
Cit1,:State: (){L nPqlLUJ;)
Phonegs/[ Zt&{*4{t+l Fax:
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CCB license rro.:/fi-n 1 BCD license no.: 6! Udq
isor's license no.
Signature of signing supervi
Print name of sigrring supervisor:,,v\
FEE SCHEDULE
Number of inspections per item ( )Qty Cost
ea-
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4)$181.00 $
Each additional 500 sq. ft. or portion
thereof s 35.00 $
Limited energy (2)$ 43.00 $
Each manufactured home or modular
dwelling service or feeder (2)$ 86.00 $
Services or feeders: installation. alteration. relocat ion
200 amps or less (2)t $ 109.00 $ lo'1
201 to 400 amps (2)s127.00 $
401 to 600 amps (2)$21s.00 $
601 to 1,000 amps (2)s277.00 $
Over 1.000 amps or volts (2)$635.00 $
Reconnect only (2)$ 86.00 $
Temporary services or feeders: installation. aheration. relocation
200 amps or less (2)$ 86.00 $
$ 118.00 $201 to 400 amps (2)
$172.00 $401 to 600 amps (2)
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: nan. alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit S 7.42 $
b. Fee for branch circuits without purchase ofa service or feeder fee
First branch circuit (2)$ 86.00 $
Each additional branch circuit s 7.42 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)$ 86.00 $
Each sign or outline lighting (2)$ 99.00 $
$ 99.00 $Signal circuit or a limited-energ.v panel,
alteration, or extension (2)
Each additional inspection: (l )s99.00 $
DEPARTMENT USE
$
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $99.00)
(B) Enter 120% surcharge (.12 x [A])$
(C) Technology Fee (5% of [A])$
TOTAL fees and surcharges (A through D):$ 0a.b
Last edited 7/1/2018 BJones
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