HomeMy WebLinkAboutPermit Electrical 2020-01-13.CITY OF SPRINGFIELDO OREGON
b Electrical Permit lication
225 Fifth Stree$ Springfield, OR 97477o PH(541 )726-37530FAX(541)726-3689
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.
h,
LOCAL GOVERNMENT APPROVAL
Zoningapproval verified? ! yes E No
CATEGORY OF CONSTRUCTION
dResidential ! Govemment I Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: ZbbB F.t,^.,jp_rl B oiAno ?n.,)
Taxlot.:
DESCRIPTION OF WORK
PROPERW OWNER
Name:
".,,U1* i3.i.l.-,. .P^-)
City State ZtP:77[71
Phone:'l - )Fax:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479 .540(l) and 479.560(t).
Signature:
CONTRACTOR INSTALLATION
City nv|laeq
Phone:Fax:
E-mail
CCB license no.: 1lqh.5{BCD license no.: zC-4C-\C
Signing supervisor's license no.: ?CJ !t
Print name of
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)I $186.00 $
Each additional 500 sq. ft. or portion
thereof $36.00 $
Limited energy (2)$44.00 $
Each manufactured home or modular
dwelling service or feeder (2)$89.00 $
Services or feeders: insta I I atiotr, alteration, relocation
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)$28s.00 s
Over 1,000 amps or volts (2)$654.00 s
Reconnect only (2)$89.00 $
Temporary services or feeders: installation, aheration, relocation
200 amps or less (2)$89.00 $
201 to 400 amps (2)$122.00 s
401 to 600 amps (2)$177.00 $
Over 600 amps or I,000 volts, see services or feeders section above
Branch circuits: nev', alteration, extension 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 $
Miscellaneous feesl. service or feeder not included
Each purnp or irrigation circle (2)$8e.00 s
Each sign or outline lighting (2)$89.00 $
Signal circuit or a limitcd-cnergy pancl.
alteration, or extension (2)$89.00 $
Each additional insPection: (1)$r02.00 $
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102'00)
$
(B) Enter 12%o surcharge (.12 x [A])$
(C) Technology Fee (5% of [A])$
TOTAL fees and surcharges (A through D)$
DEPARTMENT USE ONLY
Permit no
Date 7P
Last edited 7/l/2019 BJones
Address: 2 i^l ,<-t t
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