HomeMy WebLinkAboutPermit Electrical 2010-10-28
225 Fifth Street. Springfield, OR 97477tPH(541)726-J75JHAX(541)726-J689
DEPARTMENT USE ONLY
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Permit no.:
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issnance or if work is snspended for 180 days.
'. 'LOCAL> <;;OVERNMENTA~F>ROVAI::'::';;":'T'
Zoning approval verified? 0 Yes 0 No
"<C:,l\TEGORY'OFGONSTRUCTION:)'. . ".
o Residential
~~~~::J.Oa:i:SJTE:
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).
Signature:
Business name:
','<+<",';;,T~;,~~:{~~ff~46:~~i::{.,f~'~,EE'~SC_ Ii E_DJ)IijE't:~H}~~~}>f?~;~t*Jili;~'f1~~~~~~,~i
.Number ofiuspeCtio'~sp~!ite~ 0.. Qty.
.,-- . ,'.;. -,. ....
Cost, Total
.. ~;t~.'. ,_' cost.
Residential, per unit, service included:
1,000 sq. ft. or less (4)
Each additional 500 sq. ft. or portion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Services or feeders: installation, alteration, relocation
200 amP1 or less (2) $ 81.00 $
20.1 to 400 amps (2): - $ 95.00 $
401 to 600 amp~ (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, relocarion
200 amps or less (2)
$ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Dver 60~ 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 ofa service or feeder fee;
First branch circuit (2)
Each additional branch circuit
\
t
$ 55.00
$ 6.00
$"-:"" tv
'.
$ rn.~
~ Miscellaneous fees: service or feeder ~ot included
Signing supervisor's license no.:
Print name of signing supervi or:
Signature of signing supervisor:
~~
\\:"
~
440-2584.) (9/08/COM)
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (1)
Si',:.:iiiii!;;;~'!~:.f';';,"':::;i";':A' 'p"'pl'il"'A"N"'T'~'U"S"ET
..i!."'''i'.''>'i~Y.~~_,:~tl:J..;,,;;;~~q.1<',~1T ,. ,'" ..c',~V. _ ___: <.~-, _ _ ~,;;
$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
<~:-:\::-'//!:;i::~;:(@{::::.;{:;Y::, ';.::.~
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of [A])
TOTAL fees and surcharges (A through C):
$~o\yo
$ "1~'j.-
$ _0,' .(~
$"\.~11
SP~~N:..F.I~fiij
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. _'0. . OREGON
wWN.ci,springfield,or.us
TRANSACTION RECEIPT
811-SPR2010-00568
2741 33RD ST
CITY OF SPRINGFIELD
225 Fifth 51
Springfleld,OR 97477
541.726-3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 2010000685 RECORD NO: 81 I-SPR2010-00568 DATE: 10/28/2010
U:lj;gcFileILON "", Co,: ;.,'.,;,,'"' -6'::;' ;0;. ,c-igc::=;,;k"::t;; '.;; fl':, ;AtCO_UNtC_obELi;;;;:::",,-i;~f1Iou~'Ll:l.LJE;': ,-,""__,"., -;
Branch circuits without service or feeder -1st circuit 224-00000-426102 $55.00
-~.- -.",.
Branch circuits without service or feeder ~ each additional 224-00000-426102 $6.00
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: $71,37
I~ ::PA YMENT-TYPE' ;~;;PAY6Fi, ;"fC!\SHI ERiNMACH~06;:::-jCj::'-MM[IiI$::::.;'_;il;?,:;,;",.:y(ii;j;~.r;;---;, ;;AMOUNTPAI b"';;c::; . '-~\~1' j
Credit Card
013376
'JB Electric
$71.37
"
$71.37
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