HomeMy WebLinkAboutPermit Electrical 2010-8-26
, DEPARTMENT USE ONLY
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225 Fifth S're..tSpringlidd, OR 97477tPH(541)726-3753t FAX(541)726-3689
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Date:
This permit is issued under OAR 918-309-pOOO. Permits are nontransferable. Permits expire if work is not started within 180
daYs of issuBnce or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CA TEGORYOF CONSTRUCTION
,
Address:
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:
City:
Phone:
E-mail:
Signing supervisor~s license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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440-2584-J (9/08ICOM)
Total
cost
Nnmber of inspections per item.( )
Residential, per unit, Service included:
1,000 sq. fl or less (4)
Each additional 500 sq. fl or portioo
thereof
$134.00 $
$ 25.00 $
$ 32.00
$
Limited energy (2)
Each manufucbued home or modular
dwelling service or feeder (2)
Services or feederS: instal/atton, alteration, relocation
200 amps orless (2) $ 81.00
20 I to 400 amps (2) $ 95.00
40 I to 600 amps (2) $158.00
60 I to 1,000 amps (2) $205.00
Over 1,000 amps or volts (2) $469.00
Reconnect only (2) $ 63.00
- ~ ....... - ..-
Temporary services or. f~edcrs:- ins(a(/tii~pij; alteration, relocation-+
:200 amps orless (2). ;-:~, .;....,. '$"63-,00" - $' --
. - . .'l..,."
201 to 400 amPS (ij.:: 0::;'-;' $'87:00'" $
4011D600.mpS(2j,-,.:,.:"",' -"" .. $126.00 $
Over 600 amps or 1,000 volts; see services or feeders section above
Branch circuits: nel9. a/teratio.n. extension per pone/"
a- Fee for branch circuits with purchase of a service or feeder fee:
$ 63.00
$
$
$
$
$
$
$
Each branch circuit $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional brancb circuit
$ 55,00
$ 6.00
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel.
alteration,. 'or e>..1ension (2)
Each additional inspection: (I)
APPLICANT USE
$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
..(AtEntei ~~~tal of above reesc
.(Minim~m PermitFceS58.00)
. (B) Ent';, iZo/.,-sUrcIi3iiie (.I2'x[AD
, ,(C) Teebnolog)rF~(s%of[AJ) .... .,,_... .. .
. .TOTAL"fees nnd s'-'rcliarg$(~.~fougIi~t): .
, . :'..:$
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'" .,
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"0;" $'.':.~-. ---
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WW'W, ci: springfield .or. us
TRANSACTION RECEIPT
811-S P~;20i1 Q~,OO 161
637'5':: 'F'ST .:,:.
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CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541-726c3753
permilcenter@ci.springfieJd,or.us
RECEIPT NO: 2010000151
RECORD NO:'(8\'i~sPR201O-00161
DATE: 08/26/2010
~'DESCRIF?tION70~t\~t;~'\?jf~c::,i?r~5?Jj;~~~t~f~:~;:: ly~~L~~J:~rt~'~;j~;;i~~~~1J!~~GJ~.Q:U:NTl.Cj),t;iE~7;~- .~:;:-~~'t~A,MQQt~:t.~IJ.~':.;;i>:-~: ;~ <;': 1,::.J
Branch circuits without service or feeder - 1st circuit 224-00000-426102 $55.00
Branch circuits without service or feeder - each additional 224-00000-426102 $6.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $7.32
Iechnology fee (5% of permit total) 100-00000-425605 $3.05
. . TOTAL DUE: $71.37
~1j:iAYMENt~TiRE';;~; ::PAY<:fB4:"-;;'j"CASHfE~~NMA!;HAi:l.Ot;;;"!i":e:0.MNlE~J'~ti~f~!f!i<+:;'i~~?'i:~: l!;~1"':\~,MQQ"!LE.MD.;il::_-<:::._~' .to';1
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Check
4353
GMD ELECTRIC INC
$71.37
$71.37
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Frorn:Reynolds Electric Inc. To:5417263676
;J-;J'-f Joe tJ'l-lyrJ /1'41 e:.-<c1
Electrical Permit Application
08/24/2010 09:06
#286 P.001/00l
225 Fifth Stl"eet. Springfield, OR 97477. PH(541)726-J753t FAX(S41)716.3689
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.' DEPARTMENT USE ONLY
. CiTY OKSPRINGFIELD, OREc;o'N' .
_ I . ,I ~ ok "''' ~}.,:.
Date:
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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. .........'>"U()CAU'lGOVEI{NMENTdiAIlPI{OVAU''''';.,/i, (.,; .,>; 'i"" '6Y:.Y'iiYii:l/1:'-""""if,'EE,:SCHEDUUE;"%"."")'." .......
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Zoning approval verified? 0 Yes ONo :~~~~;~lt~~l]ll~~'i~i;t ~: .i'tC(J5t .TiltaV.
."....,.c';,'_:......., .:,i/tAt~G()l{y//O"Ji:C()NS'MUttl()N/iN'Y'i::............ ~('~Y-eL"'::, . /.~eost/;
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~sidentiaI 10 Government I 0 Commercial Residential, per unit, service Included:
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""\NtUJ(I$"t$ltE~INI1(1ltlM.tl.(INilANO.~UOCAtlON:,'!6,1t ; $134.00 $
Job site address: ~ ( ..sT 4{J'/"') r~d~500sq. fl. or portion $ 25.00 $
City, _<;r){' I .\ ( .D I Slate: 0vZ ZIP: 9- -- ~ted ~rgy (2) $ 32.00 $
RefereJce: u I Taxlot.: Each manufactured home or modular
dwelling service or feeder (2) $ 63.00 $
SO PTlONH;OFf,WOI{K,>>v::,\\,f. ':<~:~"5";:'-; .....
an ^ I....." ),.., <1./ n. .0 ('ClA, 41 Services or feeders: installation. alteration. reloca!ion
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(,)/~O~ I\AA>. ( 200 amps or less (2) I $ 81.00 $ <( I
,"....",....,.. '.!'f!I{()IlEI{TI(,'OWIllEIt.i..'....,.:!'..,:.',. . 201 to 400 amps (2) $ 95.00 $
Name: ,:-: ." /, ..A -r-r, ,.jL:'. )' 401 to 600 amps (2) $158.00 $
Address: .~r 5'" -(.{ )~) 001 10 1,000 .mps (2) $205.00 $
City: ,'f), I""" (' ,,/I I Stale: o..e ZIP: 9 NO Over 1,000 amps or volis (2) $469.00 $
Phone: :;'1(. ~':'ct _ "''' ", (/ I Fax: .' Reconncc! only (2) $ 63.00 $
,
.E-mail: , Temporary services or feeders: installation, alteration. relocation
This installation is being made on residential or farm property 200 amps or leSs (2) $ 63.00 $
owned by me or a member of my immediate family., This 201 to 400 amps (2) $ 87.00 $
property .is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $
Signature: Over 600 amps or 1,000 volts, see services or feeders section above
~;CON'MAC:rOR'INST:AIlCA'I1()~'" '., ........
. ".... '-." ".:' ':, ..... "\1; , .,' .. ... 'j _r .... '...'.. ;~\\,,;'.{'..":'eij2;\:U_,...,,;.;':.,.'.:., Brancb circuits: new, alteration. extension per panel
'.., , . ...c,', .,.,.... .. ..:.: .<i';l-."...:."o'";,o','.,,,,"'.
Business name, O. , I. -, (" .. Fee for branch circuits with purchase of a service or feeder fee;
Address: ~,,, .\ 1., .J I4u\Jl. Each branch circuit /0 $ 6.00 $ (,0
City: C. ," I State: oR ZIP: 91'ri> 2.. b. Fee for branch circuits without purchase of a service or feeder fee:
Phone:""t 't.....> .1~"'7 I Fax"""I. ~.. _ . - First branch circuit (2) $ 55.00 $
E-mail: i)...... Cih ,A. ., ~../~.."''- A"lM. Each additional branch circuit $ 6.00 $
CCB license no.: C""..,-t I BCD license no.: IJN.~')"( Miscellaneous fees: service or feeder not included
Signing supervisor's license no.: 5YOl/ S Each pump or irrigation circle (2) $ 63.00 $
Print name of signing supervisor: TQJP_~ QeTA' IJ~ Each sign or outline lighting (2) $ 63.00 $
,
Signature of signing supervisor: ~/'Q"^",,,^ t\'t Signal circuit or a limited.energy panel. $ 63.00 $
" , alteration, or extension (2)
Each additional inspection: (I) $58.00 S
~.%2Z~[Q) -
(1 /8i11D I (A) Enter subtotal of above fees $
(Minimum Permit Fee $58,00) /'froC
~ (B) Enter 12% surcharge (.12 x [A]) $ i~ 'i 1
~J( 0.. (e) Technology Fee (5% of[A]) $J. oS-
TOTAL fees and surcharges (A through C): $ iI_" <;7
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440.2S84~] (9/OB/COM)
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