HomeMy WebLinkAboutPermit Electrical 2019-09-24Electrical Permit lication lrilnor[r-o
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.
Last edited 7llt20t9 BJones
CITY OT SPRINGFIE[,D, OREGON
DEPARTMENT USE ONLY
Permit,o., [9 -oo77oI -a
,u,",J'//-/ 1
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? n yes I No
CATEGORY OF CONSTRUCTION--L -
$6esidential ! Government I Commercial
r1
ZIPState:
AN
n r
JOB SITE
Job site address
City:
T
Reference Taxlot.
IESCRTPTTON OE WORK t,
r'
Name:
Address
Phone:Fax:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. fhis'
plo^pg+_y_il not.intended for sale, exchange, Iease, or rent. OAR479.s40(l) and 479.560( I ).
Business
Address
City:State:ZIP
Phone:
E-mail:
CCB license no.:BCD license no.:
s license no
Print name of superusor:
Signature of sigaing
FEE SCHEDULE
Number of inspections per item ( )Cost
ea
Total
cost
Residential, per uni( service included:
I,000 sq. ft. or less (4)$186.00 $
Each additional 500 sq. ft. orportion
thereof $36.00 $
Limited energy (2)$44.00 $
Each manufactured home or modular
dwelling seryice or feeder (2)$89.00 $
Services or feeders: installation,relocation
200 amps or less (2)$l t 2.00 $
201 to 400 amps (2)$131.00 $
401 to 600 amps (2)$22r.00 $
601 to 1,000 amps (2)$285.00 $
Over 1,000 amps or volts (2)$654.00 $
Reconnect only (2)$89.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)$89.00 $
201 to 400 amps (2)$122.00 $
401 to 600 amps (2)$177.00 $
Over 600 amps or 1,000 volts, see seryices or feeders section above
Branch circuits: new, alteration, utension per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit $8.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)$89.00 $
Each additional branch circuit $8.00 $
Miscellrneous feer,: service orfeeder not included
Each pump or irrigation circle (2)$E9.oo $
Each sign or outline lighting (2)$t9.00 $
panel
$89.00 $
Each additional inspection: (l )$102.00 $
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102.00)$
(B) Enter l2o/o *rcharge (.12 x tAl)$
(C) Technology Fee (s% of [A])s
TOTAL fees and surcharges (A through D):
vv"ftl ros0 v r rr ll bno S.nr
,
225 Fifth Streeto Springfield,, OR97477 .PH(541)726-3753 o FAX(541)72G3689
/
-Ol fl ,t
I >l r'r f'zrP:Q7y7y
,E-mail: I
Signature:
{fi
t0 x"'
,M fll14 rt;tlf I
)tFax:'? L
4ry.
\1
t0
DEPARTMENT USE
$\
/