HomeMy WebLinkAboutPermit Electrical 2010-4-23
Electrical Permit Application
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~rTY OF SPRIN<pFI~LD, OREGO~ :
225 Fifth StreeltSpringfield, OR 97477+PH(541)726-3753tFAX(541)726-3689
DEPARTMENT USE ONLY
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Date: 4~ 2 S - to
This permit is issued uuder OAR 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.
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LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
.Residential D Government D Commercial'
JOB SITE INFORMATION AND LOCATION
Job site address:
City:
PROPERTY OWNER
ZIP: 4.471
This installation is being made on residential or farm property
owned by me or a member ofrny immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
ZIP: 0'1 "0 I
Print name of signing supervisor:
Signature of signing supervisor:
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440-2584-) (9/08/COM)
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FEE SCHEDULE
Number of inspections per item () Qty. Cost Total
ea. cost
Residential, per 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 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1,000 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) $ 63.00 $
. 20 I to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit $ 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: (I) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees $'6/.0 u
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A)) $ Q,1? -
(C) Technnlogy Fee (5% of [A]) $ LI ,n.
TOTAL rees and surcharges (A through C): rJIJ~i1
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2-/6120 1(:)