HomeMy WebLinkAboutPermit Electrical 2010-8-23
Efettrical Permit Application
225 Filth Street. Springfield, OR 97477+PH(541)726-3753HAX(~4)ln6-3689
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Penmt no,:
Date:
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This permit is issued under OAR 918-309-0000. Per;its are nontransferable. Permits expire if work is not started within ]80
days of issuance or if work is suspended for ]80 days.
,__, LQCAl GOVERNMENT AP,PROVAl..
Zoning approval verified? D Ves 0 No
~ CATEGORY; .OF"CONsTRlJCJ;ION :.
Residential
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City:
Reference:
I' 'FEE SCHEDULE '
'Numb~rof inspections per item UI" Qty: ~~~~,.
Resj~ential, per unit, service included:
Total;
cost
1,000 sq, fl. or less (4)
Each "additional 500 sq. ft. or portion
thereof
Limited energy (2)
Each manufactured home or modular;
dwelling service 9r feeder (2)
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
,. Services or feeders: installation. 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 $
.:r;-J!J\'1.j (0):to 1;000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
"'tl:'" Reconnect only (2) $ 63.00 $
Name:
Address:
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),
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CONTRACTORINs;r ALLATlON
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Business name:
Address:
City:
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ZIP:
Phone:
E-mail:
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440-2584-) (W08/COM)
Temporary services or feeders: installation. alteration, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) ,.." $ 87,00 $
401 to 600 amps (2) .. \1'Il{2'm~, $
Over 6~9.~.ps or 1,000 v~lt't~~&i\.I'~:i'iie\%,~\,Htiol1 above
B,U~~h\~r~itS\\1Jn:, n!!-<;r{!iit\.;A~~ I ~I " :.
,,:-cFt%Jili i\~'lt'ter~~,i', ,\c,hi'\~~ a service or feeder fee:
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E-'!~Mf1!ntl}\<li'c.~'1 ;:'IORIOIJ' $ 6.00 $
b. Ft~~<ir ~~WH:U1tS without purchase of a service or feeder fee:
,-
First branch circuit (2)
Each additional branch circuit
$ 55,00 $
'> $ 6.00 $ / 8
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
qach sign or outline lighting (2)
Sig)ial circuit or a limited-energy pand.
alteration, or extension (2)
Each additional inspection: (I)
"{,;!o::"',:;:.'~1~f~;:;jC"'PPUCANf:OSE \
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of[A]) .
TOTAL fees and surcharges (A through C):
$ 63.00
$ 63,00
$
$
$ 63.00 $
$58.00 $
(,":: " .\' :c,!
$ /8
$ 7'e..
$ . 10
$2 I 0.52
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~OREGON
TRANS,A:.~rJ'8NiRECEI PT
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CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
541-726-3753
www.cLspringfield.or.us
perm itcenler@ci.springfield.or.us
RECEIPT NO: 20 I 0000 I I I
RECORD NO: 81 I -SPR20 I 0-00031 DATE: 08/23/2010
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mE.$~B!.!'TIClN.,.., "e....
Services 200 amps or less
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
Branch circuits with service or feeder each circuit
~AYMEN1"TYPE" .'.
Check
1011
'I'.AVOFF':-:CASH'ER: DBOvvtSeY''':{- -..C9MMI;'nS
CARLOS GUADALUPE
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$81.00
$4.05
$9.72
$18.00
$2.16
$0.90
$115.83
{'AMClLJNTPI\U) ~.
$21.06
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State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
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224-00000-426102
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100-QOOOO-425605
821-00000-215004
224-00000-426102
,. '!'821~00000-215004
. -'100-00000-425605
.- TOTAL DUE:
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