HomeMy WebLinkAboutPermit Electrical 2019-11-26CITY OF SPRINGFIELD, OREGON
Electrical Permit Iication
225 Fifth Streett Springfi eld, OR 97477 o PH(541 )726-3753.
EPRINGFIC'LD
(
This permit is under OAR 918-309-0000. Permits are
days ofissuance or ifwork is suspended for 180 days.
Permits if work is not started within 180
-2
DEPARTMENT USE ONLY
Perrnitno.: W<iOl{bO
Date: llzcoftq
LOCAL GOVERNMENT APPROVAL
Zoringapproval verified? E Yer E No
CATEGORY OF CONSTRUCTION
! Residential ! Government ! (ionmercial
JOB SITE INFORMATION AND LOCATION
Job site address LT
City: $r5r61*Qa\"[State: 0L nP: aVITZ
ReferencJ J Taxlot.
DESCRIPTION OF WORK
*b
\J ) PROPERTY OVUTGn
f
(-2J
Name
Address
City: Soci,^rq€\.c)State: OR-ZtP: \Tltf
Phonefcilqt- lt1?-Fax:
property is not intended for
47 9.s40(t) and 479.560(l ).
sale, exchange, lease, or rent. OAR
\oo- c.r^-*E-mail:
of my immediate
onThis installation is
owned by me or a
or farm property
family. This
CONTRACTOR INSTALLX
Business name:
,\Address o,-'-.
City:"l-'-State:
. \-!-/ZIP: VJ
Phone:F tf
t l" ,r}J
CCB license no.BCD license no.
Signing supervisor's license ro.' \-
Print name of signing supervisor:
Signature of si gning supervisor:
FEE SCHEDULE
Number of inspections per item ( )Qty Cost
ea.
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4)$l E6.00 $
Each additional 500 sq. ft. or portion
thereof $36.00 $
Limited energy (2)$44.00 $
Each manufactured home or modular
dwelling seryice or feeder (2)$89.00 $
Services or feeders: installation, alteration, relocation
200 amps or less (2)t $l 12.00 $nL
201 to 400 amps (2)$131.00 $
401 to 600 amps (2)$221.00 s
601 ro 1,000 amps (2)s285.00 $
Over 1,000 amps or volts (2)s6s4.00 $
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: neu,, alteration, extension per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit Z $8.00 $)\t
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)$89.00 $
Each additional branch circuit $8.00 $
Miscellaneous fees: sen,ice orfeeder not included
Each purnp or irrigalion circle (2)$89.00 $
Each sign or outline lighting (2)$89.00 $
Signal circuit or a limited-energy panel,
alteration, or extension (2)$89.00 S
Each additional inspection: (l)$r02.00 $
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102.00)
$
(B) Enter 127o surcharge (.12 x [A])$
(C) Technology Fee (5% of[A])$
TOTAL fees and surcharges (A through D):$
Last edited 7/1/2019 BJones
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