HomeMy WebLinkAboutPermit Electrical 2019-09-30CITY OF SPRIN Gtr'IELD, OREGON
Electric al Permit A ation
225 trift[ Streeao Springtietd, ORyr477r.?n(gr)?2G37sjt
e2A|!:qFtELD
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Thir permit is issued under oAR 9rt-3094000. Permits are notrfreDste."ble. permits expire if work is not srarted within rEodays of fusuancc or if work is suspended frr iiO arys.
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E-mail:
l,ast eilited 7/l/2019 Elones
DEPARTMENT USE ONLY
\-002
JoDate:
LOCAT GOVERNIIENT APPROVAL
Zoning approval verified?lYes lNo
OF CONSTRUCTION
Residential E Govemment E Commercial
BJO INSITE FO RMATIOSI AND LOCATION
Job site address:
State:
Taxlot.
OF UVORK
PROPERTY OWNER
Name:
Address:I
r1 State ZlP 1L1
Fax:
This insallation is being made on residential or farm properly
owned by me or a member of my immediate farnily. This
propeny is oot intended for sale, exchange, lease, or rent, OAR
479.5,10(1) and 479.560(l ).
Signafure:
CONT RACTOR INSTAL LATION
Address:
ZIP:.-t
Fax:L4Phone:
E-mail:
CCB license no.BCD license no.:\30
tnsPrint narne
Sipature of signing supcrvisor:
Number of inrpectiola per itcm ( )Qty.Cost
EL Total
cost
Residentiel, per urit, service included:
1,ffiO sq. ft. or less (4)s186.00 $
Each additional 500 sq. ff. or ponion
thereof s36.00 $
Limited energy (2)s4{.00 $
Each manufactured horrp or modular
dwelling service or feeder (2)s89.00 $
Services or feeders: inslallation, al!eralion, relrcalion
200 amps or less (2)$l12.00 $
201 to 400 amps (2)$131.00 $
401 to 600 amps (2)$221.00 $
601 to 1,000 amps (2)$2E5.00 s
Over 1,000 arnFs or vohs (2)$654-00 s
Reconnect only (2)sr9.00 s
Iemponry cervicei or feeders: inslallation, alleralion, relocation
200 amps or less (2)$E9.00 S
20 I to 400 arnps (2)$r22.00 $
s177.00 $401 to 600 amps (2)
Over 600 amps or 1,000 volts, see seryices or feeders section above
Branch clrcuits: netq alteralbn, extension per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
$r.00 $Each branch ci-rcuit
b, Fee for branch circuits wiihout purchase ofa service or feeder fee:
$89.00 $First branch circuit (2)
$8.00 5Each additional branch circuit
Miscellancous feesz sen'ice orfeeder not included
$89.00 sEach purnp or irrigation circle (2)
$19.00 sEach sigo or ou0ine lighting (2)
s89.00 $Signd circuit or a limited-energy panel,
alteration, or extension (2)
$s102.00Each rddidonal inspection: (I)
DEPARTHEITIT USE
$
(A) Enter subtotal of above fees
(Minimum Permit Fce $f 02.00)
S(B) Enter l2% surcharge (.12 x [A])
$(C) Technologr Fee (s% ot[A])
$ l\q.itTOTAL fces and surcharges (A through D)
Z'd 686t69' t19 cvn H lorluoc eleLurlc eto:80 6 L 00 das
FEE SCHEDI
Cif',(,nrr iynh p.zrP:q1\17
Refererlce: I
tPal
I t'114/lt Tt*Business name: ('
I
Statz: f)k
lA,t\Ln fDr,r
t-|ly
Signing supen'isor's Ucenss no.:
Mechanical Permit Application
CATEGORY OF CONSTRUCTION
fl Residential EI Government E Commercial
JOB SITE INFORMATION AND LOCATION
Job site address:
State: p I zrP:q1Lt11
R"f*il; I Taxlot,
DESCRTPTTO{ OF WOBK
PROPERTY OWNER
Name:
Address: 2.5JO J. }irp o1
State: nP_zrP q1411
Fax:
E-mail:
This installation is beiog made on property owned by me oI a
mernber of my immediaie family, and is exempt from licensing
requiremetrts under ORS 701.010.
Signature:
CONTRACTOR INSTALLATION
(1,lrT\IJt'
Address: 4^t1 E. b% fu r(
state: otp aP: Q1L41q
Phone:Fax:l.u,v
E-mail:
vtJ,ly
Print name:2>2y'^
l.ast edited 7i l/2019 BJones
SPFI:{G:'iELf
FEE SCHEDULE
Residential Qt!'.Cost
EL
Toad
coct
Finl Annliance $102.00 s
Furnace/burner includinp ducts and vents
Up to l00k BTU,/hr,s23.00 s
Over l00k BTU,ftr $26.00 S
ff el lers"/sloves/vents
Unit hearer $23.00 $
W'ood./pelleUgx stovdflue $s4.00 s
Evaporated cooler Dl9-00 I
Vent fan with one ducUappliance tl3.00 $
Hood with exhaust and duct u9.00 $
One to four outlets 59.00 s
.A.dditional outlea (each)$5.00 $
Up to 10,000 CFM $rs.00
Over 10,0O0 CFM I26.00 s
Comuressor/absorption systeru./hert purnp
Up to 3 hpllfl)k BTU $23.00 $
Up to l5 hp/500k BTU 041.00 $
Up to 30 hp/1,000 BTU 161.00 $
Lip to 50 hp/l,750 BTU s7&00 $
Over 50 hp/1,750 BTU st32.00 $
Incinerators
Domestic incinerator i25-00 $
Enter fee based oo valuation ofmechatrical etc.$
tiscellaneous faes Cost€-To,trl
cost
Reinspectioo lr02.00 $
Specialts (equested inspections (per n02.00 $
Regulated equipment (unclassed)il9.00 $
Each sdditionrl inspection: (1)s1(n.00 $
DEPARTMENT USE
(A) Eot€r subtotal of above fecs (or entcr set
minimum fee of $ 102.00)$
(B) Investiguivc fte t
(C) Entcr 12% sucharge (.t2 rlA+Bl)$
(D) Seismic fee,TVo (.01 x [A])$
(E) Technotogy Fce (5% of [A]) .-S
TOTAL fees rod surchrrges (A tbrough E):$
Eoter total valuation of mechanical system
and instaltation costs $
225 Fifth StrEet r SpringfieH. OR 9747 o PH(541 )72G1753 . FAX(54 l)72636t9
This permit h issued under OAR 918440-0050. Permits expire if work is not started within 180 days of issuance or if work is
suspended for lto deys.
,,b,
S
DEPARTiIENT USE ONLY
-002731Permit no.
lqDateqo
;d 686169' t19 cvnH lorluoc aleurlc eeo:80 6l 00 das
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Air-handlins nnits- includins dgc s
Cammercial
Business name:
CCB license no.: