HomeMy WebLinkAboutPermit Electrical 2010-9-30
225 Fifth Street. Springfield, OR 97477+ PH(54 1)726-3753 +FAX(541)726-3689
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, DEPARTMENT USE ONLY -
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Permitno/l//-s;n. ~O/O-(JO'-
Date: 0/- 'JC?,- Z,O/O
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This permit is issued under 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.
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Zoning approval verified? 0 Yes 0 No
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D Residential D Government Commercial
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Job site address: ~Z- She, 'Ie
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Reference: ~ ~ l-7/0
" "DESCRIPTION.,
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ZIP: 017'177
Taxlot.: oct 5?J0
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Address:
City:G
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) an 79,560(1).
ZIP:
City:
Phone:
E-mail:
CCB license no.: J<{,,, 7~
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584-J (9108/COM)
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,~u m~erol;insp'e$tio'n~p'';r ite,in( .J,'J" Qty.
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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 $ $
dwelling service or feeder (2) 63.00
Services or feeders: installation, alteration. reloearion
200 amps or less (2) $ 81.00 $
201 to 400 amp's (2) $ 95.00 $
401 to 600 amp's (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amp's or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, feloearion
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
40 I 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 panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) I $ 55,00 $ ~
Each additional branch circuit I $ 6,00 $ b
Miscellaneous fees: service or feeder ':lot 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 fa /. &()
(Minimum Permit Fee $58.00) $
(B) Enter 12% surcharge (.12 x [A]) $ 7. ~Z--
(C) Technology Fee (5% of [A]) $ rr5'
TOTAL fees and surcharges (A through C): $ 7/.17
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. . ,.";. OREGON
WVNJ. ci. springfield. or. U S
TRANSACTION RECEIPT
811-SPR2010-00402
632 SHELLEY ST
CITY OF SPRINGFIELD
225 Fifth 8t
Springfield,OR 97477
541~726.3753
perm ilcente r@ci,springfield.or.us
RECEIPT NO: 2010000430 RECORD NO: 811-SPR2010-00402 DATE: 09/30/2010
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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) 821-00000-215004 $7.32
Technology fee (5% of permit total) 100-00000-425605 $3.05
TOTAL DUE: $71.37
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Credit Card
1124
ROBBINS ELECTRIC INC
$71.37
$71.37