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HomeMy WebLinkAboutPermit Electrical 2010-8-26 Electrical Permit Application I ~ <IDW lWffi[l~CG3m~<ID~ 225 Fifth Strtdt Springfield, OR 97477. PH(54 t )726-3753. FAX(541 )726.3689 DEPARTMENT USE ONLY I~ ~f~~.? p 0-0 / S :s .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) ~ ~ 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 ^ ~ ~f>$ ~ (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 . , ' www.ci.springfield.or.us . .. ;,IJ; fP Y;~'f:i;} TRANSAOTI@N RECEIPT 811-SP~~01b-00153 1064 DARLENE AVE CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541.726.3753 S~i:~. FIE~ ~~ ~'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 ~ .,,- - TOTAL DUE: $67.86 I ,PAYM_.!:NT,,' ,T,"PE' ,""lPAYOR'2";,,,' CASHIER DBOWLSBVC;:-; COMMENTs'!r i';, ' \-v" :,f,,_"::' ":"A_,M.O,_U,NT.'pAID.,:_,_:.~_. :__,_.""" _ ____..._ _',._~,J;," .~.. '~'~w~"""-,,. ..........,. .".,',,, --,-.~ ~ _..,_.~__.,." _ n ___--. _"'-' Check 3082 KIMELMAN DAVID & CLAUDIA A $67.86 $67,86 ,I'J~;_-{ },~~ t't: l~ (;.,;, '!~)I\! ! ' ....,;; ,0,';11;;; ".' ',r, .... , "~ '." ':?p-i ".; '1' .. ...,.~,~ . ! ~. ~H, '. ;.',":,j~.~.." :',~% ;1;:;. ;;-("") i~ 1 '..~ ';' '. '" ..) ,,:,"