HomeMy WebLinkAboutPermit Electrical 2010-9-2
.:!Electrical Permnt A12.:mdncation
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225 Fifth Street+Springfield,OR 974770PH(541)726.J753tFAX(541)726-3689
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DEPARTMENT USE ONLY
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Pirmlt no.:
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Date: 9,- z. - 10
This permit is issued uuder OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started withiu 180
days of issuance or if work is suspended for 180 days.
(},)SJ Each additional inspection: (I)
\})~~~~~ (A) EnlersubtolalOf~::'~~~ANT USE
NOTICE hW~ tI'linimum PermitFeeS58.00)
: . . \. ATTENT ~'i,
THIS PERMIT SHALL EXPIRE IF THE WORK follow rull;glii;ilirfiL~,1!Jr~a.I(~~~r~ to
~UTHORIZED UNDER THIS PERMIT IS NOT Notlficallo 1(e))Tecl1nordg;>,f~(r&9>1I~]~etf~;:h
,OMMENCEO OR IS ABANDONED FOR In OAR 95 i.Jl;U!.'>'i!~ef.fli?dls"l'r&l~f~~-(jJfrbugh C):
~!Y 180 DAY PERIOD 0090.. You ., .-.-" oV"'ov V. "'" IUl8S by
. calling the center. (Note: the teleohone
number for the Oregon Utility Notification
Center is 1-800-332.2344).
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
77
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Name:
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).
Signature:
ZIP: Cj'J'fo /
- qRf-/ ~gc)
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584-J (9108ICOM)
FEE SCHEDULE
Number of inspections per item ( ) Qty.
Residential, per unit, sen'ice included:
1,000 sq. It or less (4)
Each additional 500 sq. ft. or portion
thereof
Cost Total
ea. cost
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
Services or feeders: ills/allatlon. alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95.00 S
40 I 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 services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
40 I 10 600 amps (2)
$ 63.00
$ 87.00
$
$
$
$126.00
Over 600 amps or 1.000 volts. see services or feeders section above
Branch circuits: llIrw, alteration, extension per panel
a. Fee forl~8I!~h circuits with purchase ofa service or feeder fee:
Each bran~.cirtuit I S 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
I $ 55.00 $55ot>
/ $ 6.00 $ ~p
first branch circuit (2)
Each additional branch circuit
l\.Iiscellaneous fees: service or feeder /Jot included
Each pwnp or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration., or e~1ension (2)
$ 63.00 $
$ 63.00 $
$ 63.00 S
$58.00 $
$ rot. 00
$
$
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. SP.R. IN.GFIEL. ~
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CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00214
481 W N ST
permitcenler@ci.springfield.or.us
RECEIPT NO: 2010000221
RECORD NO: 8II-SPR201O-00214
DATE: 09/02/2010
LPESCRI~T.(QN:/'fcc_- ~.~ ;i,>.~'P.;':;'("~-~C:,,":;:,'~":ACC.OuN:(C.()i:>El,,;C- --l;d~MO_UNt[)_UE '. .i,>'-.:J
Branch circuits without service or feeder - 1st circuit 224-00000-426102 $55.00
Branch circuits without service or feeder - each additional' 224-00000-426102 $6.00
State of Oregon Surcharge (12% of applicable fees) i'" 821-00000-215004 $7.32
Technology fee (5% of permit total) 100-00000-425605 $3.05
TOTAL DUE: $71.37
ft,;j:fAYIVIENTJ'TYI'E~\S;I'AY0R?'J'(\;CASHIERTNM~c8ADci':'<"-7CQMMENllS/?:'j. ;:~~i;:i .,';"i;);'AMOl.lNT'f'AI[)',,,i+:;i5," . "01
Check
4363
GMD ELECTRIC INC
$71.37
$71.37
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