HomeMy WebLinkAboutPermit Electrical 2010-4-20
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~J'EI~ctrical Permit Al!Plication
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( 225 Fifth Strcet+~prin;field, OR 9;477+PH(541)726.3753tFAX(54t)726-3689
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Permit no. .'"1- OILlO
Date -9'- ;;;0-- J U
This permit is issued uuderOAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENTiAPPROVAL - ",',
Zoning approval verified? DYes D No
. '-CATEGORY OF CONSTRUCTION
D Residential D Government D Commercial
'JOB SITE INFORMArION'AND.t:OCATION "
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City: ZiP: C\ '1 '7
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Taxlo!.:
DESCRIPTION>OF .,wORK
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c' ,,"" .PROPERTYOWNER..
Name: " lie,; LL-c..
Address: A-V ~
City: is StateCl:,'-- ZiP: 'il'{o'O
PhoneSl} -Sn-S>S1:> -68{-703&
E-mail: J.Co<<..urrr- . WIl--\
This installabon 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(1) and 479.560(1).
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440-2584.J (9/08/COM)
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.' :':':'~;;.!FEE SCHEDULE' .
. . :'_ 'I' ,,- - 'l , Cost Total
Number of inspections per, item ( ) Qti.
,. , .;. -:-.~ c .. '., ea- cost
Residential, pcr unit, service included:
1,000 sq. ft or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
20] to 400 amps (2) $ 95.00 $
40] to 600 amps (2) $158.00 $
60] to ],000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) I $ 63.00 $ (P3
201 to 400 amps (2) $ 87.00 $
40] to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: ne1v, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I $ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
',. ,ApPLICANT USE
(A) Enter subtotal of above fees $~g ,v
(Minimum Permit Fee $58.(0)
(B) Enter 12% surcharge (.12 x [A]) $ 7,<;1 ~
(C) Teclmology Fee (5% of [A]) $ 3./'
TOTAL fees and surcharges (A through C); rO-!
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225 Fifth Street
Snii!lgf~ld, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000375
Date: 04/20/2010
IO:09:53AM
Job/Journal Number
COM2007-0 1405
COM2007-0 J 405
COM2007-0J405
Description
Temp Power 200 amps or Jess
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
Check
Paid By
DALE KAST
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
63.00
7.56
3.15
$73.71
Amount Paid
nJm
6568
I n Person
Payment Total:
$73.7]
$73.71
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