HomeMy WebLinkAboutPermit Electrical 2010-10-11
Electrical Permit Application
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225 Fifth Street. Springfield, OR 97477.PH(541}726-3753+FAX(541}726-3689
DEPARTMENT USE ONLY
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Date: 10,.- /1 ~ 10
Tbis permit is issued under OAR 918-309-0000"Permits are nontransferable. Permits expire if work is not started witbin 180
days of issuance or if work is suspended for 180 days. '
LOCAL GOVERNMENT APPROVAL
approval verified? DYes D No
CATEGORY OF CONSTRUCTION
o Government
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:
CONTRACTOR INSTALLATION
Business name: $~\,~~ 'E.ce::TR\c'
Address:fo SoX lob?
City: fLs::479"<Nf I U.... State:cR. ZIP:Cf 74-5".:J
Phone: 5W 9'1f).-;)o5o Fax:511- 71.f6-0g-/ g..
E-mail: f"OGL-EGHRN @) vV\SN, cc(ff\
CCB license no.: '19;)-7 Ch BCD license no.::90 - 37 3 C
Signing supervisor's license no.: 40 crt\- - s
Print name of signing supervisor: STEoB'--l Ga~
Signature of signing supervisor:
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440-2584-) (9/08/COM)
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)
Services or feeders: installation, alteration, relocation
200 amps or less (2) ?- 1-$ 81.00 $/&2-
201 to 400 amps (2) $ 95.00 $
40 I to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $.\69.00 $
Recoonect 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 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 ofa service or feeder fee:
First branch circuit (2) . $ 55.00 $
Each additional branch circuit I/~ $ 6.00 $0 I
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 limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
", . . APPLICANT USE " ~
..
(A) Enter subtotal of above fees 0/1
(Minimum Permit Fee $58.00) G? /'Y.
(B) Enter 12% surcharge (.12 x [AD $
(e) Technology Fee (5% of [AD $
TOTAL rees and surcharges (A through C): $' )(:; I.
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00491
270 24TH ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541-726-3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 20 I 0000540
RECORD NO: 81 I-SPR20 I 0-0049 I
DATE: 10/11/2010
L PAVMEN:rTVPE- ~. "pAVOR " "CASHfER:;N~CHAD0'~0-;;g,ciNfr,j_E~J:~~;';~::-'0':~_~:"~:' ; ~:_AMOUNtPAID:;
Credit Card
583338
STEVEN R GEISLER
$287.82
$287.82