HomeMy WebLinkAboutPermit Electrical 2010-8-24
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726.3689
ELECTRICAL PERMIT APPLICATION
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1. ffqlATION;'O'E;iNSTJffi'7JA!lfON!'il'[~ 3. lro.~EETE!FEE:SCHEDUiJE;JiEEOW.~~'W;':"':.~i>i1?"#f~';~
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Each additional 500 sq. ft. or ....., ':::::- a
portion thereof 0/ ___ ~ '/
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
Limited Energy/Residentia] $ 28.00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Iuspection Fee is $50.00 + Surcharges
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4. SUBTOTAEOR~O,VE2l!i,.~,t;. ".~!'Sb2~:" "'< a u-
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;";OnCri% State Surcharge / f- C; ;-
,,,,V \\;-(-1IS PE1[Or<.'~dDiihis!iativeFee= IF THE WG,.~ Y,l. r>3-
W ~'A'.") dO:~'!1>l!l')cbR~1.9~y,F~~IIS PERMIT IS NO I '.S
t'\ ~ "'" MMFi'lS'fl\.PR IS ABANDONED FOR ~ ,0
\i\ ,NY 18U lJAY fSfla~U1'Jve(T:)lBuildingFonnsIE]ectrical Permit pplication I-08.doc
Permits are non-transferable aod expire i
not started withiu 180 days ofissuance or i
Sospended for ]80 days.
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Electrica] Contractor t~ ~ j "'If All ,(IV) fb:.ruc
S, Dll-11W6 k
Address 5Db
City '1).v]~
Phone to ~ f-,(p 1J.)
Supervisor License Number _ Lj-o 14 - 5
(0) D 1
,
Lfs-g
Expiration Date
Constr. Contr. Number I
Expiration Date
<5~'
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
06/011 lOll
,
ZON
INITIALS
DATE
SOURCE
Date
(-2'1-/0
Each Manufact'd Home or
Modu]ar Dwelling Service or
Feeder
$55.00
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200 Amps or less
20] Amps to 400 Amps
401 Amps to 600 Amps
60] Amps to 1000 Amps
Over 1000 AmpsNo]ts
Reconnect On]y
$ 70.00
$ 83.00
$] 38.00
$180.00
$413.00
$ 55.00
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c. .menlPJ~~F~r.X0S~rVl.~es~or~R~~.~r.~1';.. ,,'tl r'J::-.$^f~ < > ~
]ustallation, Alteration or Relocatiou
200 Amps or less . , $ 55.00
201 Amps to 400 Amps c $ 7q.00
401 Amps t9;qO,O Amps" $] 10.00
in nAh 1''1- ,
Over 600 Amps or '1000 Volts see "B" above.
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New Alteratioliro~Exiensi~ii' Pe'f.;PaiIel-
One Circuit Center is 1.800':;:"L <$'48.00
Each Additional Circuit or with
Service or Feeder Permit $ 4.00
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CITY OF SPRINGFIELD
225 Fifth St
Springfiekl,OR 97477
541-726-3753
TRANSACTION RECEIPT
www.d.springfield.or.us
permitcenler@d,springfield,or.us
I ~~I'A YMENT. ;-,:yPFT
Credit Card
RECEIPT NO: 2010000124 RECORD NO: 811-SPR2010-00116 DATE: 08/24/2010
IDESCRIP"ION-:~f-,~G:j:r.:h_ ,,~) "C"11~::~~:: ;f;'l!,;.~li',;!~~"1t~CJ;:OUNT':'C.oQE:c;r.:t-:f--';, '11~I'!IJ:lJ:lJcjJ~PJJ_E;-' '1
Residence wiring 1,000 sq. ft or less '{ .), .:;' 224-00000-426102 $134.00
.'-;~~lo'"~ t'~
Each added 500 sq. ft. or portion 224-00000-426102 $225.00
Slate of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $43.08
Technology fee (5% of permit total) 100-00000-425605 $17.95
TOTAL DUE: $420.03
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Ken Jacobs/Christenson Electric $420.03
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