HomeMy WebLinkAboutPermit Electrical 2010-10-29
225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
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DEPARTMENT USE ONLY
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SPa.'lb'U - 00 ~O Z
Permit no.:
Date: 10 .C 1-1 C
This permit is issued uuder OAR 918-309-0000, Permits are nontransferahle. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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, altera,tion, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
.llt~ 601 to 1,000 amps (2) $205.00 $
'7 7 Jc:ll Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
", 'L;0CALcGOVERNMENT" .6:BPROVAlli?J.?,\i'(;';(i'i'i'l'(,
Zoning approval verified? 0 Yes 0 No
.".dC,6;TEGORYi'00F,;;CONSlRUCTI0Nl,;'ff'
~~
Name: s:"........
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).
E-mail:
CCB license no.
Signature of signing supervisor:
ATTENTION: Oregon law requires youto
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952.001-0010 through OAR 952-001- <<
0090. You may obtam copies of the rules by
calling the center. (Note: the tel~phone "~,,
number for the Oregon Utility Notification \ ~
Coo"";, 1-800-332-80"). ~
~
440.2584.J (91G8/COM)
~W;~'~<~f&vZY5~!~f~;N1Jt<~{0EEE~.S'CH~[j.Ul!!I;~~1-~~~f}~~,;r$;?~~.b;;~J
.,N~~~er:~f)n.~p'~,~t~'e;~~'~~T:!F~.~:p;,~;~~~:'8!r' x;~~~~' :.;. l ~~;~I ...
Residential, per unit, service .in,e1uded:
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
40 I to 600 amps (2)
$ 63.00 $
$ 87:00 $
$126.00 $
Over 600 amps or 1,000 volts, see serVices or feeders section above
Branch circuits: new, alteration, exte(lsion per panel
a. Fee for branch circuits 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)
Each additional branch circuit
I $ 55.00 $
I, $ 6.00 $
Miscellaneous fees: service or feeder',:/ot included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
$ 63.00 $
$ 63.00 $
$ 63.00 $
Each additional inspection: (I) $58.00 $
tJti1lfi~~r~t~'b,~~tJ~~~A~e'i2TCANT~~U:S.-E~(~t(:~;gi:~,~}[~~;~3'~~1j~~~::;':'~;
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00) $ bf
(B) I\r.t,~.).m.s.urcharge (.12 x [A]) .. ,. $ 73&..
(C) if'r~~~i?~r,{,r~,q;~ eM{\~) ~)(PIRF IF THE WO!$K-S Cl~
TOT:Aq~~~~~~~~";h.':~(*I~O/lgIgMlT S NI$1?,"37
COMMENCED OR IS ABANDONED FOR ' ,
ANY 180 DAY PERIOD.
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00608
770 HARLOW RD APT 410
CITY OF SPRINGFIELD
225 Fifth 51
Spririgfield,OR 97477
541-726-3753
permitcenler@ci.springfield.or.us
RECEIPT NO: 2010000699 RECORD NO: 81 I-SPR20 I 0-00608 nATE: 10/29/2010
i DESCRIPTIO/ll' '". : f__,. ':;',":' -.,-_-__2.:*-:: ;,..'. -, 'f'.'-.:AC-COUNT'CODE;:;;,; '.," .:AMOUNT DUE' .0 -- -
t!::""_"__..,~".__.___~_"._~~_~~_,~.,.,~_.,,...,_~~.., _w '_'," ....,..._. .... ..,. _ _~~....,."'_,.",....,_...._.""",._.,,"_
Technolo~y fee (5% of permit total) 100-00000-425605 $3'9~
Branch circuits with service or feeder each circuit 224-00000-4261 02 $6.00
.- "..'-----~"..,"'-"""--,,---_._~~,.__.._- ----
Branch circuits without service or feeder - 1 st circuit 224-00000~4261 02 $55.00
.--.----..---.- .~---,
821-00000-215004 $7.32
TOTAL DUE: $71.37
-z'.'::_" .' AMO_LlNT PAID - -
State of Oregon Surcharge (12% of apelicable fees)
[ . PAYMENT TYpE'
. pA 'r'bR_,;CASH~':LR:DI30W"SBY' "',cPlVIMgNJS ,.
1 ,"
. j
Credit Card
515220
COMPLETE ELECTRICAL
INSTALLATIONS INC
$71.37
$71.37