HomeMy WebLinkAboutPermit Electrical 2019-06-27Electrical Permit A lication
225 Fifth Streett Springlield, OR 97477 r PH(541 )726-3753. FAX(54 I )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.
Residential, per unit, service included:
1.000 sq. ft. or less (4)$181.00 $
Each additional 500 sq. ft. or portion
thereof s 35.00 $
Limited energl'(2)$ 43.00 $
Each manufactured home or modular
dwelling service or feeder (2)$ 86.00 s
Services or feeders: installation. alteration. relocation
200 amps or less (2)i $ 109.00 s
201 to 400 amps (2)s1 27.00 $
401 to 600 amps (2)s21 s.00 $
601 to 1.000 amps (2)s277.00 $
Over 1,000 amps or volts (2)s635.00 $
Reconnect only (2)$ 86.00 $
Temporary services or feeders: installation, alleration, relocation
200 amps or iess (2)$ 86.00 s
201 to 400 amps (2)$ 118.00 $
401 to 600 amps (2)$1 72.00 $
Over 600 amps or 1.000 volts, see services or feeders section above
Branch circuits: new. alteration. extensionper panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit I $ 7.42 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)$ 86.00 $
Each additional branch circuit s 7.42 $
Miscellaneous fees: service or feeder nol included
Each pump or irrigation circle (2)$ 86.00 $
Each sign or outline lighting (2)$ 99.00 $
Signal circuit or a limited-energy panel.
alteration. or extension (2)$ 99.00 s
Each additional inspection: (1)s99.00 $
(A) Enter subtotal ofabove fees
fl\4inimum Permit Fee 599.00)
S
(B) Enter 12ozi, surcharge (.12 x [A])$
(C) Technoiogy Fee (5% of [A])$
TOTAL fees and surcharges (A through D):s 13b.2
ffi Permitno.: lQ-UqlO -A
Date b/tq lzos
Zonirrg approval verified? E Yes I No
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Job site address: / /.t4 57* $1-,
State: Opt zrP:1f47&
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Name:
Address:
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Business name:
Address:
Ciry State:ZIP
Phone Fax:
E-mail:
CCB license no.l511 Gb BCD license no.
Signing supervisor's license no
Print name of signing supervisor:
Signature of signing supervisor:
Last edited 7/1/2018 BJones
DEPARTil'IENT USE ONLY
LOCAL GOVERNMENT APPROVAL
CATEGOR,Y OF
DESCRIPTION OF WORK
PROPERTY OWNER
made on residential or farm property
family. Thisownedof my
for sale,lease, or rent. OAR
YcO{TR cToR $N
FEE SCHEBULE
Numtrer of inspections per item ( )
Cost
ea-
TotaI
c0st
DEPARTMENT USE
SPRINGFIELD
OREGON
www. springfield-or. gov
Worksite address: 1124 57IH ST, Springfield, OR 97478
Parcel: 1702331107200
Transaction Receipt
81 1 -1 9-000950-ELEC-01
Receipt Number: 471467
Receipt Date= 6127119
TB
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR97477
541-726-3753
permitcenter@springfield -or. gov
Fees Paid
Transaction date
6t27t19
6t27t19
6t27t19
6t27119
Units
1.00 Ea
1.00 Qty
'1.00 Ea
1.00 Automatic Technology Fee
Description
Services 200 amps or less
Branch circuits with service or feeder each
circuit
State of Oregon Surcharge - Elec (12o/o of
applicable fees)
Account code
224-000004261 02-1 033
224-000004261 02-1 033
82 1 -00000-21 s004-0000
1 00-00000-425605-0000
Fee amount
$109.00
$7.42
$13.97
$5.82
Paid amount
$109.00
$7.42
$13.97
$5.82
Payment Method: Check number 4474 Payer: Leta Trask/ Bob Trask Rental Payment Amount:$136.21
Cashier: Toste Muniz Receipt Total:$136.21
Printed: 6/27l'19 4:16 pm Page 1 of 1 Fl N_TransactionReceipt_pr
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