HomeMy WebLinkAboutPermit Electrical 2010-9-2
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225 Fifth S~reet.Sprlngfield. OR 97477.PH(541)726-3753.FAX(S41)716-3689
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Permit no.:
Date:
9-Z-{ 0
This permit is issued uuder OAR 918-309-0000. Permits are uontransferable. Permits expire if work is not started within 180
days ofissuance or if work is suspended for 180 days.
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BCD license no.:~(Q-~'?;
"11 L.~
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Signature of signing sup~visQr: l~ /-
, ATTErmo.!l,oo ,.. "'"','" y" ,:';,
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the. Oregon Utility Notification
C","'1" ,.00.3"'"'''' ~ ~~
~ti,1lW~-'Y'iLOCAt:~130YERNMENT;;P;~~ROyP;LC:;:::'~ j;:l;~il':
Zoning approval verified? 0 Yes 0 No
~B:~~~tH.!~~JjC:AmE.~~.8~(~0F,J~C~NSInRUCfmc:)N&P~.:~t~4~,:!a'<";1
o Residential 0 Government Commercial
ki;1i~;J9B ~SlmE? INf;ORMA TI!ZlNiJANI:!"'l CMION"~1:fu:;i~
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Name:
Address:
E-rnail:
This installation is being made on residential or fann property
owned by me or a member afmy immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
;~:l'1111ri\il!'c~NrrM(;rr9~i)INSm,6;L!I2A';I'I~Nil$?;r;;;it;f~~li2';z
Business name:
440-2584-J (9108/COM)
,":;~~;;'??{i3!;EE~SCHEDUJ:E" i:" i
Q'ty' ; . 'Gi>st[': ;" Total i
;1''''';;: ""~~' ea~~i; '~:ii ,:;'.,c.ost'f~;~
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 $,58 'F;.J
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps orless (2) . $ 81.00 $
201 to 400 aml" (2) $ 95.00 $
40 I to 600 aml" (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)
201 to 400 aml" (2)
401 to 600 aml" (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1 ,000 volts, see services or feeders section above
Branch circuits: new. alteration, extension per panel
a. Fe~ for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$
b. Fee for branch circuits without purchase of a service or feeder fee:
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(e) Technology Fee (5% of [All
TOTAL fees and surcharges (A through C):
$
$
$
tl' '$h
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
TRANSACTION RECEIPT
811-SPR2010-00211
4011 INDUSTRIAL AVE
permitce nter@ci.springfield.or.us
7~
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www.ci.springfieJd.or.us
DATE: 09/02/2010
RECEIPT NO: 2010000219
RECORD NO: 8 I I -SPR20 I 0-002 I I
t,,,iizf-3" ..;.' " .-~'-'ckt;:E;~.,;. - :'.~AC_t.P.U NLG.OOE . -,'. 7' - -A1v10.LJMIJ:>.Ll E -
224-00000-426102 $58.00
': j\~, :; ~j ::'. 100-00000-425605 $2.90
821-00000-215004 $6.96
. TOTAL DUE: $67.86
f,PAYI'IIENfTVRE _ ;'PA vOR.i~_/:g;AsHIER!-NMAcHAiioi'~'-"'~OMMEN;rS)-'tS'- 'i.' ,< - on: .'t.-,' AMOUNT PAID
IDESCRIPTI0N,7-; .--:;:"--:~
Other Limited Ener~L__.
Technology fee (5% of permit total)
State of Ore~on Surcharge (12% of applicable fees)
; .
~
Check
16827
AMERICAN SECURITY
ALARMS INC
$67.86
$67.86
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