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HomeMy WebLinkAboutPermit Electrical 2010-5-5 Electrical Permit Application . I 225 Fifth Streett Springfield, OR 97477. PH(541)726-3753' FAX(541)726-3689 '*,~:"~__",,,~,;'''''',j:>~':oI'',,.;<.';imlt~'9'"~e....,.;;:-~~ ';:0;;:PE:PAR.IMENT"USE\0N&;y'~$ I'.~'''''''' ;,,'. .;..}... '''-''~"N:;t:.'hff~~;''~~;'''S:.~ Date: \ ~.\D This permit is issued under 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. '""~~~I!:~:Q~!-8[G0~V.EB~MEN~~.&P~~@'V;A'~~ Zoning approval verified? 0 Yes 0 No ~~~'[~A(!LE:GQBlf~c:[~~QNSJfiBJ!j:Ollji.Q1iL',' -'~~_" o Residential 0 Government 0 Commercial 'JI1fa!!?Iill.EjiN!EJi5B~~[tl0~~@1!.!!~~'Nm.0til~;%: \ \CS~ Phone: 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 renl. OAR 479.540(1) and 479.560(1). Signature: ~\'~~~Q:~rilm8A@lQJ~.'lI.I'lSjiiP.il!lr~1!H~riI~~jw*, 's tl 1y!e -ZS"'z.... I-G Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~~~" 'Q~ '~\\) ~.\9 ~ \\-~ \j:\ 440-2584-1 (9/08/COM) 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: instal/ation, alteration, relocation 200 amps or less (2) $ 81.00 $ 20 I to 400 amps (2) $ 95.00 $ 40 I' 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) 20 I to 400 amps (2) 40 I to 600 amps (2) $ 63.00 $ $ 87.00 $ $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 $ b. Fee for branch circuits without purchase of a service or feeder fee: First hranch cIrcuit (2) Each additional branch circuit $ 55.00 $ $ 6.00 $ Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alteration, or extension (2) Each additional inspection: (1) ~p'gjr@"~Nffll(!?_E:-" (A) Enter subtotal of above fees (Minimum Permit Fee S58.00) (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (5% of[A]) $ TOTAL fees and surcharges (A through q: $ $ 63.00 $ $ 63.00 $ $ 63.00 $ $58.00 $ ...~""..."",.ti""'ii!:~ --~,$j;;,~~7ti.~~~;'~ $