HomeMy WebLinkAboutPermit Electrical 2019-09-13CITY OF SPRINGFIELD, OREGON
a.
JBlectrical Permit A
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lication
225 Fifth Street.Springlield, OR 97477.PH(541)726-3753. FAX(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.
FEE SCHEDULE
Number of inspections per item ( )Qty Cost
ea.
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4)s t 86.00 $
Each additional 500 sq. ft. orportion
thereof $36.00 $
Limited energl'(2)s44.00 $
Each manufactured home or modular
dwelling servicc or leeder (2)$89.00 $
Services or feeders: installation. alteration. relocation
200 amps or less (2)$t 12.00 $
201 to 400 amps (2)s 13 t.00 $
401 to 600 amps (2)s221.00 $
601 to 1.000 amps (2)$285.00 $
Over 1.000 amps or volts (2)$654.00 $
Reconnect onll (2)s89.00 $
Temporary services or feeders: installat ion. alleration. relocation
200 amps or less (2)s89.00 $
201 to 400 amps (2)$ 122.00 $
401 to 600 amps (2)$ 177.00 $
Over 600 amps or 1.000 volts" see services or feeders section above
Branch circuits: neu'. alteration. extension per panel
a. Fee tbr branch circuits with purchase ofa service or feeder lee
Each branch circuit s8.00 $
b. Fee fbr branch circuits without purchase of a service or f-eeder l'ee
First branch circuit (2)$89.00 $
Each additional branch circuit s8.00 $
Miscellaneous fees: sen'ice orJieder not included
Each pump or irrigation circte (2)$8e.00 $
Each sign or outline lighting (2)stt9.00 s
Signal circuit or a limited-energy panel.
alteration. or extension (2)I s
Each additional inspection: ( | )s102.00 s
DEPARTMENT USE
(A) Enter subtotal of above ftes
(Minimum Permit Fee $102.00)$
(B) Enter l2%o surcharge (.12 x [A])$
(C) 'tcchnologl, Fee (5% ol [A])$
TOTAL fees and surcharges (A through D)$
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DEPARTMENT USE ONLY
Permit no., R-CD 2\'{O'El
Date:Qh zl rq
LOCAL GOVERNMENT APPROVAL
Zoningapproval verified? E Ves n No
CATEGORY OF CONSTRUCTION
[] Residential E Govemment fr Commercial
JOB SITE INFORMATION AND LOCATION
ZtP:17 Ll1 ?
s
State:
Job site
City:o \l-
Reference: A Taxlot.
DESCRIPTION OF WORK
af,n iU'\(t )lv
PROPERTY OWNER
Address
Name:
City:State ZIP:
Phone 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
47 9.s40(1) and 479.560( I ).
Signature:
CONTRACTOR INSTALLATION
Address:\Z?Ut/EW..
CtLft
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Business name:EX
City:State: 12(ZtP:Q7W O
pnonestlt-96q qob Fax:
BCD license no.CLL 15lSLoL tCCB license no
E-mail: g .Y@-
Signing supervisor's license no., { q 6 GLe*
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Signature of signing supervisor
[-ast edited 7lll20l9 B.lones
Print name of signing supervisor: f
$89.00