HomeMy WebLinkAboutPermit Electrical 2010-8-20
225 Fifth StreetfSpringfieJd, OR 97477tPH(541)726-3753HAX(541)726-3689
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not starte
days of issuance or if work is suspended for 180 days.
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Zoning approval verified? 0 Yes 0 No
';;.CATEGORYfOF.;CON~TRUCTIOt'f\,,, "
~esidential 0 Government 0 Commercial
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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:
:CONTRACrORINSTALL.Il.TION
Address:
City:
Phone:
E-mail:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584.J (9!08/COM)
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>', . _ . -"" -. .. -":..(. ", - ~ .. y'- :.' . -"~- . Cost Total
,:N.um-~er'~,f)nsp'e<:tio:ns _P~rj~r.m':(,) .,~), Qty: ',l- ;:-ea/~ i . .'cost. c.
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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)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 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) $ 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: new, alteration, extension per pane!
a. Fee for branch circuits with purchase of a 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) J $ 55.00 D":::
Each additional branch circuit ) $ 6.00 $ (.&
Miscellaneous fees: service or feeder I}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: (I) $58.00 $
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(A) Enter subtotal of above fees $ !&/ ( :yO
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [AD $l/t/ ..
(C) Technology Fee (5% of [AD $ '6 nee
TOTAL fees and surcharges (A through C): $ ./ I (...) ~
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CITY OF SPRINGFIELD
225 Fifth 5t
Springfield, OR 97477
541-726-3753
TRANSACTION RECEIPT
w.NW. ci. springfield, or. us
permitcenter@ci.springfield.or.us
RECEIPT NO: 20lO000lO4
RECORD NO: 811-SPR20 lO-OO I 02
DATE: 08/20/2010
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Branch circuiIs wiIhout selVice or feeder - 1 sl circuit
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Branch circuits wilhout selVice or feeder - each addition at .:~ '.. .,.
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Stale of Oregon Surcharge (12% of applicable fees) ....: . ,,:' :,".
Technology fee (5% of permit total) .i. ",. . ., .
::iACC.O.i.JNT,,.C.OOE~";.:rii,...< '-:Ar.IIP.Ut)llP9.I:': '>.
224.00000-426102 $55.00
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224-00000-426102 $6.00
821-00000-215004 $7.32
100-00000-425605 $3.05
TOTAL DUE: $71.37
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$71.37
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LRAY.MENT,ifyRl:b....-PAyOR.-;-;~CAsHIER:NMAc.~IKDo.~ ";:CPMMENJ.S .
Credit Card DAVID WILLIAM WEBB
035652
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