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HomeMy WebLinkAboutPermit Electrical 2010-8-26 Ele'ctrical Permit Application - 225 Fifth Street. Springfield, OR 97477+PH(541)726-J75JHAX(541)726-J689 , . DE-F>ARTMENTUSE ONLY . . '^~"';,,' . " . ~(O-OO I Z Dale: r,..z(; .(0 This permit is issued uuder 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. . " ';COCAL:G0VERNMENTAP'I'.BOV A,"~ye;~r;i'T". Zoning approval verified? 0 Ves '0 No ;:, ,):,,(;. S,{CATEGORYiJ(jF.;'CONSTRUCTION~~" , o Residential 0 Governmenl 0 Commercial ~~~'~tOB_~SITE~:INJ;(jR.M,lI;TION!;AND~CClCAtl()N'\'l~'!j'i~~F Job site address: 'i~;,h,<,-.<.-'<- City: De- ZIP: Q. \ Taxlo!.:' :. 'DESCRIPTION: OF' WClRK'.";' 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: Business name: 'S....,(\ Address: Signing supervisor's license no.: Print name of signing supervis ,Signature of signing supervisoL ATTENTION: Oregon law requires you to M ~ foUow rules adopted by the Oregon Utility \))~~).): !'Iotlflcatlon Center. Those rules are set forth ".V In OAR 952-001-0010 through OAR 952-001- 'V' 0090.. You may obtain copies of the rules by calling the center. (Note: the telephone . .;-.. number for the Oregon Utility Notification \j"'" Center is 1-800-332-2344). 440-2584-J (9/08/COM) \~~'j~~;11~~f!~A;~~r.~~fr0i,~~9f;,~ fEE,~lS'C H t:'D):JtiE-~~;i0~!ji?~;);i~1~~lttit~~~~1~ - .-:......-. .' >\-~-' ,...' + ~.. .-",. , CosC:. . Total J.~u~~er ~()n~pe~iIo~#'p_~:~.i,t~,in;'(.)1t~;~.' 'Qty. " _ ,. ~1' '. _ .'..' .. ,.~~.-,.-,.-,_, '.," ", '.l '._ 1.,_; .... ..-, ''-' .-j:~::l~:'" , .cosL '. 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 $RI - 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: I(V Each branch circuit L( I $ 6.00 I $,.) Lj- b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 55.00 I $ Each additional branch circuit "$'jj~ Miscelll~~ 6~~ service .or /f~d"f'{(f~Y,i;8 ~J::': lCo 01 Each PU~l1l%ifl\S~~ atB-1H S Pt'n:l~f $ Each siglJl,~'W~ Illiir IS I\B S-lU' "$ 63.00 $ Signal cirtW\l&MriJ!fif~q~"f'i_~' $ 63.00 $ alteration,-R{\R't<\~0ril Each additional inspection: (I) $58.00 $ :fZ~~~~jfffi2frt~~f~l~~;~'~~~Rei2ICANT~~)JSEj~b:_:1'fk~~~;~iN5!:)~t;~1i:~;:.;) (A) Enter subtotal of above fees $ /0< (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [AD $ 1'L 6 (C) Technology Fee (5% of [AD $ 5'Z TOTAL fees and surcharges (A tbrough C): $ 117 . 1./ o s~ - .. S~~~NG;EL~, ~. ~;O'RfGON www.cLspringfietd.or.us TRANSACJION RECEIPT 811-SPR'261'b~'00162 . "-'~."'" . -, " 16'7:3,' ~F'ST CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726-3753 permitce nter@ci.springfield.or.us IlECEIPTNO: 2010000153 IlECOIlD NO: 81 I-SPIl20JO-00162 DATE: 08/26/2010 [0- ES' CRIP"T'ION"'" ~",,,,.,,,,, ",."~,3;",m"""-~"'-f"""~' " I~ - ;' ,,,SiY?;';;',,-,-. ,~,'''~''':r'?''r;~*;;$:':::,'''~ :~,;;;:r~,,","':~'^ Services 200 amps or less Branch circuits with service or feeder each circuit State of Oregon Surcharge (12% of applicable fees) TechnologY fee (5% of permit total) ~~~~'V'~C.C_6@T~C:QREFi?q',.,I-;~;~:iMQl)~,ft~QlJE .~ ;7"'. ;;' ,- ;1 224-00000-426102 $81,00 224-00000-426102 $24.00 -------~- 821-00000-215004 $12,60 100-00000-425605 $5,25 TOTAL DUE: $122.85 .-rP'AYOR<'.:::;g;A:sHrER:~DB:OWi1SBY';'f;r:'c'6MMEI.jTStl'''';p:.,~",~';;;: Y'{i~.'rii-"':":;AMOUNTP AID .' ,; cc' -! . _ _~ ;,. . '. .. _.".__-.-.,_--:_~._.~__._1.4.t4 . - .~...__.____.._~.___.~__.;J [:'!PAYMENT,T.VPE,r;.. Credit Card 013626 . roberf rogers $122.85 $122.85 ~.-':."1.~ "., , P'lc)',, ~\h {;ie'I"',. I '~!:I\:,~j'- ':-! d.\,.:I . '-, '~Yl:3'i ;~ ~.~ \ I....' " "\i, f:"~'}~.:f (/,y~<~,.:.(.. I'" ",,' .~ 'l~~;l