HomeMy WebLinkAboutPermit Electrical 2019-08-087 OB/08/2019 13:53 Builders Bectrie · (F AX)541 485 4055 P.001/001
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225 Flffll Streett Sprl11efteld, O R '7fflt PH(541)726-3753t FAX(54J)7U-3'99 •
DBPARTMENT U8E O N LY
Pcnniino.: -00/638
Date: 9
Thia permit 11 l11ued under OAR 918-309-0000. Permit, are nontnnsferable. Permit, expire tr work 11 not 1t1rted wlthi• 180
days ollun1nce or If work l11u1pended for 180 days. ·
LOCAL GOVERNMEN'i' APPROVAL
Zoning approval verified? 0Yes 0No
CATEGORY OF CONSTRUCTION
CJ Residential I CJ Government I E2I Commercial
JQl;l 81TI; INFOR.MATION AND l,.OCA'flON
Job site address: 3995 Marcola Road
City: Springfield I State:OR I ZIP:97477
Reference: I Taxlot.:
DESCRIPTION OF WORK
New Construction
PROPl;RTY OWNER
Name:
Address:
City: I State: IZIP:
Phone: . . I Fax: - .
E -m ail:
T his installation is bei:t;ade on residential or farm property
owned by m e or a m em of my Immediate family. T his
property is not intended for sale, exchange, lease, or rent OAR
479.S40(1) and 479.560(1).
Sittnaturc:
CON"tRACTOR INSTALLATION
Business name: Bullders Electric
Address: 185 Madison St
Cit)': Eugene I State:OR I ZIP:97402
Phone: 541..485-0922 I Pax: 541-485-4055
E -m ail: info@builderselectric.com
CCB license no.: 4298 I BCDlieenseno.:20-12C
Signing supervisor's license no.: 4903S /1
Print name of eigniM sus,ervisor: Jo~; R~ ~y
Signature of signing supervisor: ~ ;i~A -
PEI SCHEDULE
N.a,ber of lupecdou per Item () Qty. CGlt Total
el. colt
Ratdeatt1~ per Hit, ,errice laclwded:
1,000 sq. ft. or Jen (4) $)86.00 s
Blob additional 500 sq. ft. or portion SJUO s thereof
U m lted ellcr&Y (2) S4UG s
Eich cn111u~ hom e or modular SIUO s dwelling eavlce or feeder (2)
Senice1 or feeden: il'lstaflalion. oltuotiol'I, relocaliol'I
200 am pa or lcee (2) 1 suuo S112.00
20 I to 400 unpa (2) S131.00 $
401 to 600 mnps (2) s221.00 s
601 to 1,000 IIDPI (2) S285.00 $
O ver 1,000 amps or voile (2) 5654,00 s
Reconneor only (2) SH.ff s
Temponry Hffica or leeclen : in1tollalion, ohrratlan, relocation
200 am pa or len (2) Sl'-00 s
201 to 400 llllpi (2) Slll.OG s
401 to 6001mp1 (2) S111,00 s
O ver 600 am ps or 1,000 volt,, RO IIOrvieca or fecdcrt ,ec,don above
Bn acla circuit,: new, o/t,,otion, uten.rion per panel
a. Fee for bnm cb circuits w ith purcbu c of a ICJ'Vlec or feeder tee:
Each branch cim ilt 18 SB.Ill S144.00
b. Fee fbr branch ciroulu w ithout purcbu e of a •rvioe or feeder fee:
Pint branch cim ait (2) SIUO s
Each additional w ench circuit Sl.01 $
M luell1Deo111 tea: 11rvtc1 or /11du not lnclwhd
Eaoh pw np or irrigation circle (2) seuo s
Each 1ign or oudinc llahtlna (2) SIUO s
Signal cirw it or I lim ited-cncr1Y panel, sa,.oo s ahcration, or extcMton (2)
Eacb 1ddlttoul lupectloa: (1) sm.oo s
DEIIARTMENT U8E
(A) Enter subtotal of above feel 1258.00 (Minimum Permit Fee 1102.00)
(B) Enter 12% eurcharge (.12 x (A]) s 30.72
(C) Technology Fee (8% of [AD s 12.80
TO TA L fees and aurcharges (A throuah D ): S299.52
Ltst edited ?n/2019 BJoae,