HomeMy WebLinkAboutPermit Electrical 2010-10-29
225 Fifth Streett Springfield, OR 97477tPR(541)726-3753tFAX.(541)726-3689
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bE~>~RiMENT USE ONLY
SPRINGFIELD"
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Permit no.:
07
J
Date: /0 ~ 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.
E-mail:
CCB license no.:jc2/-7/'7LJ I BCD license no.: c.4J!.Ii.
K'l.t.. "7 <5
Print name of signing supervisor: 1""-._1 \" (Ore') Vf"
Signature of signing supervisor' / ~ ~/
~
ATTENTION: Oregon law requires'you to
follow rules adopted by the Oregon Utilityti&1%~eRfl\f~~;;f;il!?fAReiliCgNt~DsE~~i\€i,i;j~M1):1)im::i,r;}k:;',j
Notification Center.. Those rules are set forth ('\ ,,' (A) Enter subtotal of abovefees .
inOAR952-001-0010throughOAR952-001-~~1 (Minimum Permit Fee $58.00) . $ br
0090. You may obtain copies of the rules by to.\) ~
calling the center. (Note:the telephone ~V (~: E~ter 12% surcharge (.12 x [AD" $ 7JE.
number for the Oregon Utility Notllicatlon . ~ NI )(G):Tec~noJ.g!lX'~7,~(We:~~y}1t \F 1HE WDK~ $ -:lor
Center is 1-800-332-2344). '0 n .'J.<?;fi~vl~~~~~~SJ!(9'~l\~ftWtlt~Cj~" $ '7/"1" 7
~ ~ AI] IIIV'''~ DONtl! run
~ COMMENCED OR IS ABAN ,
ANY 180 DAY PERIOD. '. .
1"-" :"!"-~bCAL~:GOVERNMENTAf1f'~OVAIK~,'''~''-i'Y1i',i'ir,;.
Zoning approval verified? 0 Yes 0 No
1;-'; .;.';ii",;, '~:CMEGORY;:;.OF;;CONSTRUCTIOt{\,,%.'<;,. " ,.:,' .
o Residential I 0 Government '-f..m Commercial
~li~:'J,OB'iiSITE\'jINFORMArIQN~'iAN(j2il2bC'AT;IQN~l*~~11
Job site address: 7?D l1'ar1~",,- ~ ~'1./"'"
City: <;o!; <)0 S; 'StatoO K I ZIP:
Reference: /7c.> ~ '2oz'34 T Taxlol.:OZJ-~
, , '. ';' 'DESCRIPTION OF'WORK"':";,::).:,,::
MOV~ \;-- 0.\..-\.1. ~QL)\'-"(.;Q f)eV~A~
.
'PROP.ERTY OWNER c: cc'
Name: .5k..... ~rc:... -=-- L. 7_ .
Address: 200 t{J-.,l'itr4Iit60./r{ ~A~/C(o
City: '5.Jk.~ I State:04.. I ZIP <<7" 3 0'
I Fax:
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 renl. OAR
479.540(1) and 479.560(1).
Signature:
'.CONTRACTOR INSTALLATION . "
Business name: Le....-iJ) Q.Te () e0,-r l \
Address:37/~~' J /_QW\o"~ -<;'\......L:o}.e {Cd
City: L.. n~:'':::;~'' StateO<<-" ZIP:g14zc;,
Phone r:;z; )-22.1; -:7'iSG'71 Fax:
Signing .supervisor's license no.:
440.2584-1 (9108/COM)
S};:~~~,;'~:i~:~l:rltif~~b,~%1f;1'1f.~'I:E:e~~,sfp.R E.[jJjDE~;;{.1~~~~~~~~2W~~~'i;t!~$iJ:~
~.~~~.~~r' ~f;Jni~~\~i~-i~j',;~~!'):t~:~~,(T,1~~.< ;Rtf" -';..~~~r ;. \.-.1~~~-,'.,
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft. or portion .
thereof $ 25.00 $
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 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)
201 to 400 amps (2)
401 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, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$
$6.00
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
I
(
$ 6.00
$ 55.00
$
$
Each additional branch circuit
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
$
$
Each sign or outline lighting (2)
$ 63.00
$ 63.00
Signal circuit or a limited-energy panel,
alteration, or extension (2)
$ 63.00
$
Each additional inspection: (I)
$58.00
$
.
.
SPR.U'~GFIEl.~
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. ;;::~, OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00607
770 HARLOW RD APT 310
CITY OF SPRINGFIELD
225 Frfth 8t
Springfield,OR 97477
541-726-3753
permitcenter@ci,springfield,or.us
RECEIPT NO: 2010000698
RECORD NO: 811-SPR2010-00607
DATE: 1 0/29/201 0
I DESCRIPTION , T ,'" ~ol; 4'". ~ \;~,,;;;t~;3L,,~~~c:::c.Q@T.C"QDE~" ~-'.!!\I\IIQ.U.!'lLD.ll~;: -, . 1
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
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $7.32
Technology fee (5% of permit total). 100-00000-425605 $3.05
TOTAL DUE: $71.37
!:pt,YI'I!E!'lT:::.TYP~.ii"...,pE(O_~.- , :HASHIER:DB~WL~BE~J::~o)IJIMEN:Ilt:.::' ' ::.':..:'~ '" 0..~M.QiJ.!'lLp..NL~_~
Credit Card
515220
COMPLETE ELECTRICAL
INSTALLATIONS INC
$71.37
$71.37