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HomeMy WebLinkAboutPermit Electrical 2010-9-13 ElectriCal Permit Application I 225 Fifth Street. Springfield, OR 97477+PH(54J)726-J75J. FAX(S4I)726-J689 ..., '. 'bE~tRTM.ENT USE ON.L Y Pennit no.: 5,( 0 .00 zas Date: 9~/3 . ( 0 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. ," ";UOCjl.LiGO\lERNMENT .:AP.~ROVAlEft?:\;i:fi'!')?i:'R'j:: Zoning approval verified? DYes D No ,!i<',ft..>i,:'cMEGORv:KOF:;CONST:RUCTlONY<;!;\ D Residential D Government rzl,Commercial ~~E'.:JOBj7SIT:E4UN~ORI\IiA;HONlJAN[j1.1l1o.CATiIONf~1i~mti:r; <JT- City: S ZIPC? 7 'f 77 7 3ZOZZ-C Taxlot:OI,OO . : .DESCRll'tION;OF..w()RK'.,i:..:,:\.:,;,:.hY;;f;....~ ci'-! -S Name: 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). ZIP: Signature: City: Phone:S"}- . E-mail: CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: laW requires you to ATTENTION: Oregon b the Oregon Utility . folloW rules adoPte~h:Se rules are set lorth Notilication Center. rough OAR 952-001- In OAR 95, 2-001-0~{~~hcoPies otthe rules by 1\(\. .f'\ 0090. 'fou may 0 al Note: the telephone \y tJ>..':\-I calling the center. (on Utility Notilicatlon ~. number lor the. or1~~00_332-2344). Center IS ~ ~ 440.2584-J (9/08/COM) \y ' 2:~V.::;,1*~~'}~~~:fiq~,th\::f;~mi7:iI;E'E~S'CH EJj.QeE~9~'1t~~~t1ft~~1:~~?$'~~~}t~3 '. . :'.', ',',.'. ....:0.,.": :' '" .. Cost, I' 'Total' ,'.N~~~"~-~;.?,f,!,'~!~~5!~?,:r!;,-.H~t:!~~~,~;:~\' ,g.:q~~. .>,:4~a~~, ," \~. 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) I ! $ 32.00 $ Each manufactured home or modular $ 53.00 $ 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 ser~ices 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 orfJeder~.s~~tfon~~J)Qve BrancG!c'i}IJ;\8~w.!;it"'f'A'f'I em\WiP~fpllilf. VV~~~ a. Fee for:~r~n ~ /ils ~ltn.o....hjtl'\\<8' <P-li:R-l'I\l br~;;~W fee Each/~}iric~:f.~W'-;r\ nR IS ABA~DU"t:$1 ~'60" ,$ b. Fee f6t~io/i~ikrir\'\'~r'f~Vt-l0>\lr.chase of aseivice or feeder fee First b~~~ch circuit (2) $ 55.00 $ \ Each additional branch circuit $ 6.00 $ . Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) -. $ 63.00 $ , Signal circuit or a limited-energy panel, / $ 63.00 $63 alteration, Or extension (2) Each additional inspection: (1) $58.00 $ f~JgE~\~i~:j;zrJ@j~WifN~{ftt~;ARei1'1ci\Nt{XUS'E*i.,i~~..;~~~g:~f,fitt:t)~'~fY:; (A) Enter subtotal of above fees (Minimum Permit Fe. $58.00) (B) Enter 12% surcharge (.12 x [All (C) Technology Fee (5% of [All TOTAL fees and surcharges (A through C): $ b 1 $7S(, $ ) II $7~~ W'NW. ci. springfield, or, u s TRANSACTION RECEIPT 811-SPR2010-00283 '.;--.., -l . 3318 GATEWAY ST CITY OF SPRINGFIELD 225 Fifth $1 Springfield, OR 97477 541"726~3753 permilce nler@ci,springfield.or.us RECEIPT NO: 20 I 0000304 RECORD NO: 8 I I -SPR20 I 0-00283 DATE: 09/13/2010 [p~~CRIP-TlbN'~,",1'~';'~i' ,_-~ry5::"-';i-~F:, ;p't;0~*C:;';:~",'ii:,,:' i-ii:;_C:O.UN:(C_OQE::+:"';%l?':',,~ :'~[\II9J-!NLl2.UJ::- 'I Signal circuit(s) or limited-energy panel, alteration, or extension 224-00000~426102 $63.00 Technol09Y fee (5% of permit total) 100-00000-425605 $3.15 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $7.56 TOTAL DUE: $73,71 I' PAYMENUYP.E,:j::"'\BAYOR:~:,'g~s8.iER::DBol'Vl.sl3i~;;"CQM[\IIf:'t:!IS1f::S:;;-:'.':;'::,';' :.:,";'-:0, . A"'10UNTPAID Credit Card 213162 GLOBAL SECURITY & COMMUNICATION INC " $73,71 $73.71 . ~,. ~ , JF'" .,).,(., " , 1- '''\' 'l '.., 1. i, " .. ,'. .- _ .~ I ,:.J 1... .' ,_ ,';'A'''' '-~'''' - ,"-j I ~ 'I' ',\/" ''-''',' . ";'. " , '-:, , , . J'~7:..f) 1 f.\ ;. ! ,'.V.,"_.....J-.., .-n\'. ~w;:fl.\ !".;_~/v. . ,"~', -