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HomeMy WebLinkAboutPermit Electrical 2010-10-19 r' "' Electrical Permit Application , - ~ . , '. ,'. .",~ <0' ~~,,t' -. ~ ~'. , ,~QrtY<OirSPRINGEI]t':tD"'Xi!REGON~'~ ~'?!'i _If,' _' L" " ,~,,' ":'t ~<,4-.~l~'j~~j'~,"'.,~'!i '" l~~"':(lf'..\ 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689 s~:~ ~, ~."- "I.W!h,,,,,'a,, IllIJI "<I DEPARTMENT U~EON,L y s./iZOtb -DO S3 9 PennIt no.: Date: /0 -( - / C::> 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' "," " 'J 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). 7lf7 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'- \,/LO . \0 . 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 $ .;::~::;fii:'it;it'Q;;tji\it;t~~,:'ARJ?t1tAN'[itlJSE'X:':: !}i;{:,Eit'.::,;':.,;; (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 :: .~ ~"~ < 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 .'_ . ,I ~J Check 13305 LlVEWIRE ELECTRIC INC $78.39 $78.39