HomeMy WebLinkAboutPermit Electrical 2010-10-19
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Electrical Permit Application
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225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
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DEPARTMENT U~EON,L y
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PennIt no.:
Date: /0 -(
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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. .
LOC~VGOVERrilMENT AP,P.ROVAl' .'
Zoning approval verified? 0 Yes 0 No
,'.CATEGORY.'()F'CONSTRUCTION' "," "
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PROPERTY OWNER
Name:
Address:
City:
Phone:
E-mail:
This installation iibeing 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).
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Signature:
,CONTRACTOR INSTALLATION
Business name:
Address:
City:
. Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
ATTENTION: Oregon law e
follow rules adopted by the regon Utility
Notification Center. Those rules are set forth
in OAR 952-001-001 0 through OAR 952-001-
0090. You may ob!ain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notificat:o::." ~
Center is 1-800-332-2344). ~)i'-
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440-2584-J (9/08/COM) ~~~
'. "" ; ('.;}';':':"?/i:g;~~;~?X': FEE'i SCH EDJH~Et-;I:';1:.~"i~}'itW;~:P:1~~~~+~~{~;Pf:
<. ' ".. .. ...Cost'l:rota!
Number' of inspeciio'ris per it~m () Qty.
" -, -"'.-' -,'. -,.. " '; .- .. ,',ea., . . cost.
Residential, per unit, service included:
1,000 sq, ft, or less (4) $134,00 $
Each additional 500 sq. ft. ("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 $
20t to 400 amps (2) $ 95,00 $
401 to 600 amps (2) $158,00 $
60 t 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 $
40 t 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 se'rvice or feeder fee:
Each branch circuit I $ 6,00 T $
b. Fee for branch circuits without purchase of a service or feeder fee:
First bra~ch circuit (2) I $ 55.00 $ '1.5
Each additional branch circuit "7- $ 6,00 $ 12-
Miscellaneous fees: savice or feeder !lot included
Each pump or irrig'ation circle (2) $ 63,00 $
Each sign or outline lighting (2) $ 63,00 $
Signal circuit or a limited-energy panel, $ 63,00 $
alteration, orextension (2)
Each additional inspection: (1) $58,00 $
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(A) Enter subtotal of above fees 1/7
(Minimum Permit Fee $58.00) $
(B) Enter 12% surcharge (,12 x [A]) $ '7<.dt(
(C) TfS(f9~!'lf.:!:ee (5% of [AD .r "n~,,~"?'5
TOT{l.:1t: fJ'<i' @j1,~r~qr&lUgek6\Yih~'6,jpl/ ~ f' c ~'~~:i7~j7
HORIZED UNuth ,n'v , "., , ,
AUT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
....
~S~~INGFIElD
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~"~ < OREGON
TRANSACTION RECEIPT
811-SPR2010-00539
1644 T ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
permitcenter@ci,springfield,or.us
RECEIPT NO: 2010000609 RECORD NO: 81 I-SPR20IO-00539 DATE: 10/19/2010
!OESCRIPTION,,-c;-" ,f~' - ":~,:' -~,:-?,- ..,: ""," .;.iG_G_QLiNJlG.Q.~~~ ",-;",--~:"AiviojJNTDJjJ7,,, 'j
Branch circuits with service or feeder each circuit 224-00000-426102 $12.00
Branch circuits without service or feeder - 1st circuit 224-00000-426102 $55.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $8.04
Technology fee (5% of permit total) 100-00000-425605 $3.35
TOTAL DUE: $78,39
P.,.PAYMENLJYPE. · {PAVOR';' "cAsH/E~"qBo~__C_QM!y'-ENtS'~?i;:,-~',~:'-"-J\MOUNT PAID
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Check
13305
LlVEWIRE ELECTRIC INC
$78.39
$78.39