HomeMy WebLinkAboutPermit Electrical 2010-10-29
c rical Permit Application
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225 Fifth Streett Springfield, OR 97477+PH(54J)726-J753+FAX(541)726-3689
I"~ DEPARTMENT USE ONI..Y
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Sf"~LO~OO be
Pennit no.:
Date jC-Z 1. /0
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 if work is suspended for 180 days.
,', '" . ":LOCAL~GO"ERNME/IIT'.A.F1PR0VAt~Sp~'l>'1i;";.\"~
Zoning approval verified? 0 Yes 0 No
',1CATEGORY)!OF.:c0NSTROCTION')j' "
Name:
Address:
City:
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).
Fax:
Signature:
E-mail:
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
ATTENTION' Oregon law requiresyouto
,\ I . db the Oregon Utility
follow rules adopte, Y es are set forth
Notification Center. T~~se r~~ OAR 952-001-
in OAR 952-001-~~t~~n ;~~ies of the ruies by
0090. You may N te' the telephone
calling the ~~n~:~cio~ Utility Notification
number6~~te~is 1_800-332-2344).
~~~
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440-2584-) (9/08/COM)
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~ .' _'. "",', _, 0;", ~., ._,~.'~ ' Cost Total'
,Numberofinspecii(;ri~'perjtein;() :,; Qty. 'j,
.' ",,:,',~... ,j~,"'i'" ,,',,;;,.,..!,,:,;,..~,..:',~;,+r' "'1.', .U1':,." :.,-.~ ."ea." , .. 'c(jst ;,
Residential, per unit, service included:
1,000 sq. ft. or iess (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ $
dwelling service or feeder (2) 63.00
Services or feeders: installation, altetation, relocation
200 amps or less (2) $ 81.00 $
20i to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to t ,000 amps (2) $205.00 $
Over 1,000 amps or vollS (2) '. $469.00 $
Reconnect oniy (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or iess (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) I $ 55.00 $
Each additional branch circuit I $ 6.00 $
Miscellaneous fees: service or feeder ,!ot 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: (I) $58.00 $
~ti~~1N;~n~flifff~~~w~ARel;fcANt~:OS'E'~~i~}~g~~'~~~it1i0~~;J;?[::~':;:
(A) Entr;;r subtotal of above fees $ b(
(Minimum Permit Fee $58.00)
(8) Enter 12% surcharge (.12 x [AD $ 77%
11!~rT~Qoiogy Fec (5% of [AD " $ ~e.r
'HfS>*b.f.~Ija,~g,~s (A throu~h 0;- $ ..." ~'7
''''Il...Ir,~v I \ "
AUTHORIZED UNDER THIS PERMIT IS NOT'
COMMENCED OR IS ABANDONED FOR .
ANY 180 DAY PERIOD.
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S\~~G,~, FI~,L~
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,..-~ OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00606
770 HARLOW RD APT 210
CITY OF SPR]NGF]ElD
225 Fifth 5t
Springfield,OR 97477
541-726-3753
perm itcenter@ci.springfield.or.us
RECEIPT NO: 20]0000697 IlECOIlD NO: 81 ].SPR20]0.00606 DATE: 10/29/2010
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Branch circuits with service or feeder each circuit 224-00000-426102 $6,00
Branch circuits without service or feeder - 1st circuit 224-00000-426102 $55.00
821.00000.215004 $7.32
100.00000-425605 $3.05
TOTAL DUE: $71.37
f.. "A' y' M'E'N'T"T'y'n,E' '.'c- 'r,nA' '.y, O'R:i-..;"c, ASH,IER,':'.oBOVvi:SBY '~.".C' _Q'.'M--M' 'ENTS"";;;;".-,~; , 'AMOUNT nAID
[ r; .-.- . _ . .,;..p i-;,;,;::,:,~._, _..-'-...!:__. · -.
.?tate of Oregon Surcharge (12% of applicable f~es2
Technology fee (5% of permit total)
-j
1
Credit Card
515220
COMPLETE ELECTRICAL
INSTALLATIONS INC
$71.37
$71.37