HomeMy WebLinkAboutPermit Electrical 2010-6-16
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Ihe~t~ical Permit Application
CITY OF SPRINGFIELD, OREGON
225 Firth SlreettSpringfield, OR 97477tPH(541)726-3753tFAX(541)726-3689
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DEPARTMENT USE Or'lL Y
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Permit no.:
Date: ? -/&- /()
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.
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: (I)
ATTH TION: Oregon lawAPE!~I~
follow \(k)slllft\RlItllii Ifqy, allr~t;I;'set forth
Notilica 1~~(;;iinnJ~~'.!', .;R{j >.uA:~I\!A 952-001-
in OARl'm-Em~rdBrl!lll1rOOpl. e~IQM\WJJules DY
0090. ~ .
callin :fI\1\Q~l!01l1O!iY ttlq~1, \lfrAW' . . .
numb ~f~<~ _ _ @~4\\ through C):
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? Yes 0 No
CATEGORY OF. CONSTRUCTION
iI
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D Residential D Government Commercial
JOB SITE INF.ORMATION AND LOCATION"
Job site address: I'Y\ a I WI
City:
Reference:
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Name:
q7lf#
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
479.540(1) and 479.560(1).
Signature:
Print name of signing supervisor:
Signature of signing supervisor:
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NOTICE: . \1.re+(W
r~~SH~~~~~ SHAll EXPIRE IF THE WOR~
COMMENCED ~~DER THIS PERMIT IS NOT
ANY 180 DAY PER:~;BANDONED FOR
440-2584-) (9/08/COM)
F.EE SCHEDULE
Number of inspections per item (~ Qt)'.
Cost
ea~
Total
cost
Residential, per unit, scn>ice included:
1,000 sq. ft. or less (4)
Each additional 500 sq. ft. or portion
thereof
, Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$134.00
$
$
$ 25.00
$ 32.00 $
$ 63.00 j;
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Services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
601 tu 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
$ 81.00 $
$ 95.00 $
$158.00 $
$205.00 $
$469.00 $
$ 63.00 $
Temporary services or feeders: installation, alte..ration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 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
$ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
$ 63.00
/ $ 63.00
$
$13
$ 63.00 $
$58.00 $
$ C3
$ 7.S-C;
$ 3. IS
$ /3. 7 )
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000705
Date: 06/16/2010
2:02:54PM
Job/Journal Number
COM2010-00752
COM2010,00752
COM20 1 0-00752
Description
Sign - Outline Lighting Each
+ 12% State Surcharge
+ 5% Technology Fee
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Item Tot.l:
Amount [)ue
63.00
7.56
3.15
$73.71
Payments:
Type of Payment
Check
P.id By
METRO SIGN & AWNING
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
njm
1587
In Person
Payment Total:
$73.71
$73.71
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6/16/2010