HomeMy WebLinkAboutPermit Electrical 2010-10-18
Electrical Permit Application
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225 Fifth StreeH Springfield, OR 97477. PH(541 )726-3753. FAX(541 )726-3689
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Pennit no.:
Date: /0 . I 'i -( 0
This 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.
.' ,L<;icAIS>GOVERNMI:N"tv;APPR,b'ifAL",.>.
Zoning approval verified? DYes D No
CATEGbR.Y. OFCONSTR.OCTIQN.
Residential D Govemment D Commercial
JOB..SrrI:INFbR,MATlbN;ANO';i!(5cATION:. )
Job site address: 5/ Z Z 5 .f' ~
City: ZIP:
Name:
Address:
City:
PhoneS''}1 "fSJ. C:
E-mail:
This installation is being made on residential or fann 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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State: 6 f2. ZIP:'77'/87
'-!ZZ-3 '735" ..25-0<:>
City:
Phone:
E-mail:
CCB license no.: 15Co30 ';? BCD license no.: ;;20- SoS~
Signing supervisor's license no.: C;
Print name of signing supervisor:
Signature of signing superviso .
ATTENTION: egon law "quires youto
lo\loW rule I dopted by 'n~I~~ea~~~~~~;ih
Notificatl Center. ThhOSe r hOAR 952.001-
. OAR 0::>2-001-0010 t roug
In y Y obtain copies of the rules by
0090.. OLl ma (Note: the telephone
nC:~I~~r %~ f~;~;~gon Utility Notification
Center is 1.800-332.2344).
440.2584.) (9/08/COM)
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~~..rmbe.f~ii<<~~;cl[~~~~~~ite-';'6" "IQtY- Cost Total
'"c>+;",,,L' . . v",',; .' . 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) $ 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 panel
a Fee for branch circuits with purchase of a 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 $5S:~
Each additional branch circuit 1 $ 6.00 $ <,-d'D
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 $
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(A) Enter subtotal of above fees $~/'~
(Minimum Perm it Fee $58.00) (B) En~~rN:V~\s~arge (.12 x [AD ~~]";iT
(C) Te~~ql~~fmf~ mM\l'l.l EXPlRE n. II"' c.~v~;..so.r
TOTAHJ~~~~-'fll.!ii~tlIIrg.m ~.'V $" -" 77
NCED OR I::; Abl-\I~UU"'" , , -
COMME
ANY 180 DAY PERIOD.
...
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00431
5122 B ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenler@cLspringfield,or,us
RECEIPT NO, 2010000601 RECORD NO, 81 I-SPR2010-0043 I DAn:, 10/18/2010
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Branch circuits .with s~rvice or feeder each circuit 224-00000-426102 $6.00
Branch circuits without service or feeder - 1st circuit 224-00000-426102 $55.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $7.32
Technology fee (5% of permit total) 100-00000-425605 $3.05
TOTAL DUE: $71,37
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Credit Card
210648
TURNBO CARTER ELECTRIC
INC
$71.37
$71.37