HomeMy WebLinkAboutPermit Electrical 2019-12-19ONLYusEARTMENTDEP
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q1/Date:
Electric alP ermit cation
?75 l.ifrh Strtet t SPringfield'oR 9747?. ?H(54r)7?6-3?53 r IAx(s41)?26-36t19
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This
days
oerrnit is issucd under OAR gltt-309-0000. Pcrmits
il #;;;;;;ir*ott is suspcnded for 180 drvs'
are nontransfcrablc' Pcrmits cxplre if r*ork is not started wlthin 180
I Yes No
Zoning
Re t'cre nce:
Comrnercial
D
State:
OF
I
n CovemrnenttrRcsidential
Job site address:
JOB
Taxlot
ZIP:
ZIP:State
Natne:
Address:
Fax:PhoneiJdf-{fl . 11LY
E-rnail:
Signaturct
r propedy
This
rent. OAR
rNs
Business name:
Address
nP, q-qdlcitv: (nl0,ritr,-State:0p.-
Fax:Phone:(( 111b\W-
E-rnail: fqa+BE Salo^a^(Ux .Lw
CCB license no., (OSal?'tscD li..nr" no.: fi-p5q15
Signing superuisor's license no.: lqq - SiG
Print name of signingsupelisor: bro/. SO").,t . Plag
Signature ofsigning supe.uisor: {
LE
Total
costCostel'
includcd:servlccunit,perResidcntirl,
$$1 86.00
1,000 sq. ft. or less (4)
$$35.00Eacb additionai 500 sq, ft- or Portion
thereof
s$44.00Limitcd cnergy (2)
J$89.00armodulorhomemanufacturcdEach
feederorservice (.2)dwelling
relocationalteralion,inshllation,feeders:orServices
$$112.00200 anrPs or less (2)
$$131.0020 t to 400 amPs (2)
$$221.00401 to 600 amPs 12)
$$285.00601 to 1 ,000 amPs (2)
$$654.000ver 1,000 nmps or volts (2)
$89.00 $Reconnect onlY (2)
ro.localionolteralinn,installalion,or l"eeders:servlceSTemporary
$$89.00200 arnps or less (2)
$$r 22.00201 1o 400 amps (2)
$$177.00401 to 600 anrps (2)
Over 600 arnps or 1,000 volts. see setvices or l'eeders sectitln above
Branch circuits t new, ultcratktrr, exlensbn per ponet
a. Fee for branch citcttits with purchasc ofa sctvicc or feeder fee
$$8,00Each branch circuit
b. Fee lor branch circnils without purchase ofa service or feeder fee:
$89.00 $First branch circuit (2)
$8.00 )Each additiolal branch circuit
Miscellaneous t'ees: sen,ice or feecler nol incltded
$8e.00 $Each pump or inigation circte (2)
ItH,ach sign nr outline lighting (2)s89.00
$Signal circuit or a limited-energy panel,
alleralion, or extcnsion (2)s89.00
$Each additional inspcction: ( I )$lo2.oo
(A) Enler subtotal of atrove t'ees
(Minimum Perrnit Fec $102.00)
s
(B) Enter 1 27o surcharge (.1 2 x [A])$
(Cl) Technoiogy Fee (5% oi[A])$
TOTAL fees and sure-hargcs (A through D):$
Last edited 7lll20l9 B,Iones
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Numher of insPeetions Per item ( )
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