HomeMy WebLinkAboutPermit Electrical 2010-8-24
225 Fifth Street. Springfield, OR 97477 HH(541)726-375H FAX(541)726-3689
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",:.. '. DEPARTMENT USE ONLY
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Soil- 2010-00 \ I 't
Permit no.:
Date: l?"'ZL{- rO
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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Zoning approval verified" DYes DNa
(;,';'i::\",',;lCMEGORYJc5f~<::ONSl'RUeTION":!j ,
D Residential D Government acOmmercial
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Job site address:
City:
Reference:
c.Lr
740\
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:
'CONTRACtOR INSTAllATION
S
Print name of signing supervisor:
Signature of signing supervisor:
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
~otification Center. Those rules are set forth ...."U ~
In OAR 952-001-0010 through OAR 952-001- ~ \ ~V.
0090. You may obtain copies of the ruies by 1\ ~ J>c,:
calling the center. (Note: the telephone' \J\.~
number for the Oregon Utility Notification
Center is 1-800-332-2344). - ~
440-2584-J (9/08/COM) ~-
. , " C" ",'" . '.,,; - ".~
,Num~er of,insp'e~tioni p~r ite,m Ov..Qty.
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Residential, per unit, service included:
1,000 sq. ft. or Jess (4)
Each additional 500 sq. ft. or portion
thereof
$ 32.00
$ ..,
$134.00
$
$
$ 25.00
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$ 63.00
$
Services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
601 to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
$ 81.00 $
$ 95.00 $
$158.00 $
$205.00 $
$469.00 $
$ 63.00 $
Temporary services or feeders: installation, alferation, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders'sectlon above
Branch cJrf~\t~~~~, alteration, exte
a., Fee for;b~.ch~'FlRf\'\w]
Each br~cncl@uUIE
I'"\U ".~
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder '!ot 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 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
:,~:~t~~~~(~i~i,;'t~:~'p.'~tic,~NIlusEI'~:f\1;~i.5.~*~iG;?Jf;;:Y;. ._~ ~
(A) Enter subtotal of above fees
(Minimum Permit E ~.lIO).:>
(8) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of[A])
TOTAL fees and surcharges (A through C):
$58.
$
$ 2$"0
$
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CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
TRANSACTION RECEIPT
www.cLspringfield.or.us
permitcenter@cLspringfield,or.us
RECEIPT NO: 2010000126
RECORD NO: 811-SPR2010-00JI9
DATE: 08/24/2010
rDESCRIRtION~1~ :,.;; ~-;fifTJ;.:' X' ~:'4:,Sj .':'ti~i, 'f: "-!-:. -;,:!~ :'.AccdJJ N'T~C::di:)E, -. ., 'i:: _'" . ~M(:i.UI'IJjR.U): - ...cJ
Security Alarm 224-00000-426102 $58.00
Technology fee (5% of permit total) 100-00000-425605 $2.90
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $696
TOTAL DUE: $67.86
F,%?f'AYMENT;TYf'E .",-~,PA.YOR' --"C~SHI€,,-:l)aOWlSBf~~X'S(;PMMENItSi~":::}-':': '; .'. T:~?::::~~MQUNTI~IR--" - ,I
Credit Card odysseyav $67.86
052144
$67.86
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