HomeMy WebLinkAboutPermit Electrical 2010-8-26
Electrical Permit Application
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225 Fifth Strtdt Springfield, OR 97477. PH(54 t )726-3753. FAX(541 )726.3689
DEPARTMENT USE ONLY
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.26-/0
Date:
This pennit is issued under OAR 918-309-0000. Permits are nontransCerahle. Permits expire iCwork is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
esidential
Reference:
Name:
City:
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 rent. OAR
479.540(1) and 479.560(1).
Signature:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
C"", '" ''00.'''.'34''. ~~~
440-2584-J (9108/COM) ~
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11
FEE SCHEDULE
Number of inspections per item 0 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 $
201 to 400 amps (2) $ 95.00 $
401 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) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $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. Fe~(~of-P~~~circuits without E.'!W!~f\' ~erdr!~~r fee:
Fi;~;J!\"'.'qbE.W.oJ\l12ptmLL. "':.',,' IIEr N\n5~~U -~cJ:,
'_7.7-
Eaehi'f1f!it,i2natblilt:1\!~lWl\\i" "o,L'.>.\ 10m .E'$ li;\oli' $
M' II -... '~'J!';~H>i~}.' f~~fr not included
Isceva.9~9.us1 ees~}~, i~r%
~ ,,'" 1~\ 1 ~bil~L . . $ 63.00 $
Each p,wnp.or'lrngatJ n clfcle (2)
Each sign or outline lighting (2) $ 63.00 $
Signal. circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspedion: (1) $58.00 $
APPLICANT USE
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(A) Enter subtotal ~~: ;.D)
(MinimUIh Permit e $58.00
(B) Enter 12% surch~12 x [A]) $~
(e) Technology Fee (5% off A]) $ .:J.P5.
TOTAL Cees and surcharges (A through C): $J5'p....::.-
b 7 '36
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www.ci.springfield.or.us
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TRANSAOTI@N RECEIPT
811-SP~~01b-00153
1064 DARLENE AVE
CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541.726.3753
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~'OREGON
permilcenter@ci,springfield.or.us
RECEIPT NO: 2010000138 RECORD NO: 81 I-SPR2010-00153 DATE: 08/26/2010
!DESCRipTlON:: :.,~"1ii,;~I;;'Ycr~~~I2tI'... "::'~0it5;II\}til':\;;2rj\:'~G&PXj~Jlci0iiE:P,";~'C:tsi~AMQ.l.!.t:lT DJJ.!:' '!'
Branch circuits without service or feeder - 1 st circuit 224.00000-426102 $55.00
Balance of Minimum Electrical Permit Fees 224-00000-426102 $3.00
Slate of Oregon Surcharge (12% of applicable fees) . , 821-00000:215004 __,_._~.
Technology fee (5% of permit total) . ,100,06000-425605 $2.90
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- TOTAL DUE: $67.86
I ,PAYM_.!:NT,,' ,T,"PE' ,""lPAYOR'2";,,,' CASHIER DBOWLSBVC;:-; COMMENTs'!r i';, ' \-v" :,f,,_"::' ":"A_,M.O,_U,NT.'pAID.,:_,_:.~_. :__,_."""
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Check
3082
KIMELMAN DAVID & CLAUDIA
A
$67.86
$67,86
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