HomeMy WebLinkAboutPermit Electrical 2010-11-10
.Electrical Permit Application
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CITYDF SPRINGFIELD, OREGON
- 1-
225 Fifth Street. Springfield, OR 97477+PI/(541)726-37S3+FAX(54I)726-3689
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_DEPARTMENT USE ONLY
S~2DIO-CO 58/
Penmt no_:
Date:
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 ifwork is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF.CONSTRlJCTION
o Residential 0 Government Btommercial
JOB SITE INFORMATION AND LOCATION
3-33'3 IJe,( Or
Ie (, State: cJ .-
C .41 h / pf. Taxlo/.:
DESCRIPTION. OF WORK
Oi<"? "'" J f) 1/1 e,qM...J
. 70,5 ZZDC> 4(0l.
PROPERTY OWNER'
: flMc... it
131 ~ /'f7"
e-
".
Name:
Address;
c
City;
Phone:
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 ).
Signature:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
law requires youto
ATTENTION: Oregon b the Oregon Utility
iollow rules adopte1h y e rules are set forth
Notification cent~~1 0 t~~OU9h OAR 952-001:
in OAR 952-001- . 0 ies of the ru\es~y
. 0090. You may obtain ~ofe: the telephone
calling the center. (on Utility Notification
number for the. or1~~OO.332-2344). ~" ,,~
Center IS ~ (
440-2584-J (9/08/COM)
NO
TH
AU
\D COMMENCED OR IS ABAN
\\ ." ANY 180 DAY PERIOD.
~J?-
-+ . FEE SCHEDULE
Nu~ber ofinspections per jte~ 0 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 eoergy (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 I $ 6.00 $
b_. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
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, 1/ $ 63.00 $b~
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
. . . . APPLICANT USE
(A) Eoter subtotal of above fees $ b>
(Mioimum Permit Fee $58.00)
J!l:). gnter 12% surcharge (.12 x [A]) $ 7)''''
. ~(9:f'!(~lJr/q1't~\\'iel(~'~9fIWlllF THE WORK $ 31'
~:1Ri~';f~ ~~~wrFlti\fg"t(RMl;rolig~\cH $ 737(
DONtu rUr\
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00581
3333 RIVERBEND DR
CITY OF SPRINGFIELD
225 Fifth St
Springfleld,OR 97477
541-726.3753
permitcenter@cLspringfield.or.us
RECEIPT NO: 2010000660
RECORD NO: 811-SPR2010-00581
DATE: 10/26/2010
;V~';.:- ,4:);'i;;;~'''~.(:t~:~~0~~1.~~_:r~~~~::~ ~C~G~6.liNf.ic:p:Q(~~;Z&.~\J\:~~l,4;~~~tbj:iHJi9]~-;-- _0:~i t " :,,:1
224-00000-426102 $63.00
100-00000-425605 $3.15
821-00000-215004 $7.56
TOTAL DUE: $73.71
~,PAYMENT TipEfi:k;;:RAYORi"""'CASHJ~~-:piio\I'{I.SBy:;;;i.iftc;J;1MNfE~..:r.S1'-:r"'j;. ",;, ''f:~''i;' .,".cAMQUNtFi~ID ";'};
~ESCRIF'TI6N:"!;"" ';:';3">~':i
Data I Telecommunications
Tech~91".~y fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
.~
Credit Card
026658
CACHE VALLEY ELECTRIC
COMPANY
$73.71
$73.71
,