HomeMy WebLinkAboutPermit Electrical 2010-10-27
Efectl'ical Permit Application
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225 Fiftb Street+Springfield, OR 97477tPH(541)726-37S3+FAX(541)726-3689
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Date: 10 . 2- 7 -( 0
This permit is issued uuder OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissnance or if work is snspended for 180 days.
LOCAL~~ GOVERNMENT'~APPRO"AL ~:,:.
Zoning approval verified? DYes D No
r,~r ~i'..CATEGORY. OF:,CONSTRUCtION.,:",,'., .~
ommerciaJ
Name;
Phone:
E-mail:
This installation is being 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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Business name:
<....
Address; tf?D.
City:
ZIP: '77'-117
E-mail:
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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ATTENTION: Oregon law r:6~~e~X~i:i~y
follow rules adopted by th ules a~e set forth
~otification cen:e~'16~~~;Urgh OAR 952~001-
In OAR 952~001 Obtain copies of the rules by
0090.. You may 0 Note: the telephone
calling the cen~r. ( n Utility Notification
number for the, r1e8g000_332-2344).
Center IS -
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440-2584-1 (9108/COM)
',d- ,-: ,',,'1, ;,' ..:-i'FEE 'S:CHE[)UI!.E"'::f',~,;;
~nn;b~r~fi~sp~~~o~l~;~i~jnf)"T -Q~: ','~~ ' '!iotal
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Eacb 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 $
401.10 600 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 circ~its with purchase of a service or feeder fee:
Each branch circuit I $ 6.00 I $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) I $ 55.00 $55'"
Each additional branch circuit ~ $ 6.00 $'50
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Eacb sign or outline ligbting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
~ '0'7"
(A) Enter subtotal of above fees $&>
(Minimum Permit Fee $58.00)
(B) Enter 12% surcbarge (.12 x [AD < $ f02~
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, iv)-ili""PDology Fee (5% of [AD .,.",nn $
h~qi:~~fAA~:(9"'Wch'il'r:~J,l'(~ . " $Cj <:' f(j
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AUTHORIZED UNO BANDONED FOR
COMMENCED OR IS A .
ANY 180 DAY PERIOD.
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~OReGON
www.ci.springfield.or.us
TRANSACTION'RECEIPT
811-SPR2010-00594
117 S 14TH ST
CITY OF SPRINGFIELD
225 FifthSt
Springfield,OR 97477
541-726-3753
permitcenter@ci,springfield.or.us
DATE: 10/27/2010
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$30 00
$55.00
$1020
$4.25
------ -----
TOTAL DUE: $99.45
L'..PAYMENTTYPE1:"'~'PAYOR:.~~~CASHIER: DBO'!'lLSBY :;:~~(0MMEtojIS~,:.;':" ~~. ", .,;, to:;:. "AMOUNT'PAID
IDESG.RII'?TI<:fN""'","*"i 0: ,~.~7.' :(.i:;':::'%f""'""~".G.:',:.;;2:il:S:"/"';..6:C.C.O.@:r:c.bpE
Branch circuits with service or feeder each circuit 224-00000-426102
Branch circuits without service or feeder - 1 st circuit 224-00000-426102
State of Oregon Surcharge (12% of applicable fees) 821.00000.215004
Technology fee (5% of permit total) 100.00000.425605
RECEIPT NO: 2010000677
RECORD NO: 811.SPR2010.00594
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c:..
Check
1892
kidd and company
$99.45
$99.45