HomeMy WebLinkAboutPermit Electrical 2010-10-27
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! 'Electrical Permit Application
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225 Fifth Strtet+Springfield, OR 97477+PlI(541)726-3753+FAX(541)726-3689
DEPARTMENT USE ONLY
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Date: (). 27-(D
This permit is issued under OAR 918-309-0000. Permits are ~ontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
~ Residential D Government D Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 135 1st- S-t
City, I State: 0 ZIP:97'f'l1
0']:5 ( 2. Taxlot.:
DESCRIPTION OF. WORK
~LlJ SE-R.UICE- .- C}V:tttJ6E.
Name:
Address:
CityS
ZIP: CfIJ"~
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:
Cd,
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
~otlflcatlon Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
0090.. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344),
440-2584-1 (9/08/COM)
FEE SCHEDULE
N urn ber of inspections per item ( ) Qty. Cost Total
eo. 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) Senrices or feeders: installation, alteration, relocation
200 amps or less (2) I $ 81.00 $ 9,[ f9-
20 I 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 pwnp 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: (I) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees $ 8/
(Minimum Permit Fce $58.00)
(B) Enter 12% surcharge (.12 x [AD $ 0/ 7t
(C) Technology Fcc (5% of [AD $ 'fOr
r.9;rA\-.~s and surcharges (A through q: . $ 9tJ77
,....... ~ IV....
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00596
735 21 ST ST
CITY OF SPRINGFIELD
225 Fifth 8t
Springfield,OR 97477
541-726-3753
permilcenter@ci.springfieJd.or.us
RECORD NO: 811.SPR2010.00596 (lATE: 10/27/2010
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224-00000.426102 $81.00
100-00000-425605 $4.05
821-00000-215004 $9.72
TOTAL DUE: $94.77
L.RAYMEN] TYRE .~ f'A'(OR..:.;....(CA~HIER'.DB9W1sily:. ~ . 'COMMENTS -", : :',:~. ",,,1'.,;,,"';' ~':':AIVIOUNf'RAi5-1"IF:.- .~' ':'1
RECEIPT NO: 2010000679
lDESCRij:itioN~:7'3': '0':':""""
Services 200 amps or less
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
Credit Card
399750
bhm electric
$94,77
$94.77
,