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HomeMy WebLinkAboutPermit Electrical 2010-9-2 ( cl\\l~ ~ )?;",<,<\ - 12. 't; I fYV\ - ~ ) 225 Fifth S~reet.Sprlngfield. OR 97477.PH(541)726-3753.FAX(S41)716-3689 ~~ S.Y'~urIO - 00 -Z 't 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. ~ BCD license no.:~(Q-~'?; "11 L.~ \). 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~ I 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~ . .j 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 :ll~/O/..~, \ ., ., . ~ ~', J . , >';;1-:7-', ", . '),,:: ,j ':.~;j'~~" ",. - . \-~. /1 ", , ,_, .. I ,. ,. .- J