HomeMy WebLinkAboutPermit Electrical 2010-8-19
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CITY OF SPR1NGFIELD, OREGON
225 FIFf,H STREET ~. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION .
City Job Number '011- Sr'~010'- ()OOP3 Date fi!-19~/o
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LEGAL DESCRIPTION: A.:~~~filrulil~~1g~l1ijfI1lliim~~;rg:~l~~1
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J~ESCRIPTION:
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Installation, Alteration or Relocation
I 200 Amps or less
Constr. Contr. Number e. LjD~ I~ leFll 201 Amps to 400 Amps
,
/ 40 I Amps 10 600 Amps
Expiration Date ") -{ -II _ 05- c; -(0
, Over 600
7S,.i.gcna. e ofsuperv.~iSingc!JEle, Cfdln~'.cian .J' D.
New Alteration or Extension Per pane,!
One Circuit $ 50.00
Each Additional Circuit or with /
(lo' / /l a -;., ~ /' Service or Feeder Permit _ $ 5.00
Owners Name ~x.v..V\(L(. ~ n fl tl Y
Clf'1 r-r- ~ Et~.!t;'!i11[~0ifu~iit'14<ft:~~:;"!J"cl1$1i:~f.;'&'~
Addressn<{ ( I <;-, E. 1JI~!'~~lt\lJ,lJl1l~"*\~~~!5,~!~~~s.r~!,j>r!l!~}2a)~~!~!!'~!a!!&~
City ~ ( ot'<-f71 Phone g
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Permits are non-transferable and expire if work is
not started within 180 days ofissnance or if work is
Suspended for 180 days.
Electrical Contractor
OREGON ELECTRIC SERVICE
Address PO BOX ?n7
EU~WE, GR 9H02
City. Phone :='I...\~ - 1 6 'is- \
Supervisor License Number , ~ q ~ .s
Expiration Date
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OWNER INST ALLA TION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
~
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Inspection Request: 726-3769
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$121.00
$ 22.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$57.00
L . . 4 ~~~~JI!:!i!!"ll!p_ftii!liiliij'a'"ll!2!!iif''''''~~
B. . $~rv~~es,u~~.E~~~~;-,iI~~nl!ti'1li; 'i\lt~faJi!,ns,or4~~I()S1ti()I1,~~
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 73.00
$ 86.00
$143.00
$186.00
$426.00
$ 57.00
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c. .i!L~l!lI!!l!!.ryjJj!!im ~~M?!i!ll.eAA!il'S~ .......... .' A:'.' ;
$ 57.00
$ 79.00
$114.00
Pump or irrigation $ 57.00
Sign/Outline Lighting $ 57.00
Limited EnergylResidential $ 29.00
Limited Energy/Commercial $ 52.00
Minimum Electric Permit Inspection Fee is $52.00 + Surcharges
4. E~1PL~~i&m1llllllllllll 0/. 0'0
12% State Surcharge
10% Administrative Fee .
5% Technology Fee
i/5:J
TOTAL
Shared Drive(f:)JBuilding FormslElectrical Permit Application 7-Q8.doc
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TRANSfi.'CTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
permitcenter@ci.springfield.or.us
RECEIPT NO: 2010000098
RECORD NO: 81 I-SPR20JO-00093
DATE: 08/19/2010
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224-00000-426102 $6.00
,.,224-00000-426102 $55.00
.'224-00000-425604 $17,00
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" "224-00000-425604 $79.00
821-00000-215004 $11.52
1 00-00000-425605 $4.80
821-00000-215004 $7.32
1 00-00000-425605 $3.05
,TOTAL DUE: $183.69
t{rPAYME:Nti,TYRE--,,,4~RAYOR.":;:ZY-!CA~J~futJMAi:HA6~,,le:&MMgflll$!1~~~:;3"'f2",,,C '''''0~''?!'AM,QUNT~~J.l.IR' -
Credit Card Oregon Electric Service ..",,':/:; ,:pr~g!'D.,E!e!'tric ?ervice , $71.37
LP_;SCRIPT1Q.i!,".:r' ;' :~, ''''h "- :'.:_ . " :' -- ;::"'1;":::;",:,:.
Branch circuits with service or feeder each circuit
Branch circuits without service or feeder - 1 st circuit
Air Handlin~ Unit up to 10,000 cfm
First Appliance Fee
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
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