HomeMy WebLinkAboutPermit Electrical 2010-4-29
Electrical Permit Application
:GITY OF SPRINGFIELD, UREGOrN ~;
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225 Fifth Street+Springfield. OR 97477+ PH(541)726-375J + FAX(541)726-J689
DEPARTMENT USE ONLY
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Pennit no.: C9 - ()) p~
Date:
This permit is issued uuder OAR 918-309-0000. Permits are uontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
lOCAL GOVERNMENT APPROVAL
Zoning approval verified? DYes D No
CATEGORY OF CONSTRUCTION
Residential D Government D Commercial
JOB SITE INFORMATION AND lOCATION
Job site address: SO 1#
City.
Name:
City:
Phone:
E-mail:
This installation is being made on residential or fann 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).
Signature:
CONTRACTOR INSTAllATION
E-mail:
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor'
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440-2584-J (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 $
20 I to 400 amps (2) $ 95.00 $
40t to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over] ,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 $
40 I to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or fceders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase ofa service or fccdcr fee:
Each branch circuit I $ 6.00 I $
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) Entcr subtotal of above fees $ 1St:;
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (. ] 2 x [All $ /C?
(C) Technology Fee (5% of[All $ 7-
TOTAL rees and surcharges (A through C): $/xL
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