HomeMy WebLinkAboutPermit Electrical 2010-8-20
Electrical Permit Ap lication
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225 Fifth St,ee,.Sp,;ngfield, OR 97477+PH(541)726-375HFAX(54I)726-3689
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DEPARTMENT USE ONLY
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This permit is issued uuder 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.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
~dential D Government D Commercial
JOB SITE INFORMATION AND LOCATION
0(01
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:
Address:
City:
Phone:
E-mail:
Signing supervisor's license no.:
Print narn~ of signing supervisor:
Signature of signing supervisor:
440-2584-J (9108/COM)
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FEE SCHEDULE
Number of inspections' per item () Qty. Cost Total
ea. cost
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 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2) Sen'ices or feeders: installatfon, aJteration, relocation
200 amps or less (2) $ 61.00 $
201 to 400 amps (2) $ 95.00 $
40 I to 600 amps (2) $156.00 $
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, relaeaUo!,
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: nely, alteration, extension per panel
a Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit I $ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) I $ 55.00 $5S.c~
Each additional branch circuit ,- $ 6.00 $ t,plO
Miscellaneous fees: service or feeder not included
Each pump 'or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a Iimited-energy panel, $ 63.00 $
alteration, or e:-'1ension (2)
Each additional inspe'tino: (I) $58.00 $
APPLICANT USE .
(A) Enter subtotal of above fees $/01.00
~linimum Permit Fee S58.00)
(B) Enter 12% surcharge (.12 x [A]) $
(C) Technology Fee (5% of [A]) , $
TOTAL fees and surcharges.{A through C): $71,&"
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~OREG'ON
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CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
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TRANSACTION RECEIPT
www.cLspringfield.or.us
permitcenter@ci.springfield.or.us
RECEIPT NO: 2010000108 RECORD NO: 811-SPR2010-00106 DATE: 08/20/2010
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Branch circuits without service or feeder - 1 st circuit . \::';~ :;;i;J.!_ i 2~~.,00000-4261 02 $55.00
Branch circuits without service or feeder - each addilional';.: .224-00000-426102 $6.00
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Slate of Oregon Surcharge (12% of aePlicable fees) 821-00000-215004 _____ $7.32
Technology fee (5% of permit total) 10~:<!~~.:.425605 $3.05
TOTAL DUE: $71.37
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Check G.M.D Electric $71.37
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