HomeMy WebLinkAboutPermit Electrical 2010-10-1
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Electrical Permit A
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225 Fifth Street+Springfield, OR 97477. PH(541)726-3753+ FAX(541)726~3689
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Permit 511l . 0 0 '-lIP
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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.
? ;'.~.2'",'L'OC)l;C;GOVERNMENT'r'APPROVAL. . '~i ..'
Zoning approval verified? DYes D No
~bZJ1r;zlli~1L:~,,:; FCArEG()R'(:-OF-V~(jNST~OCTION
o Residential 0 Government 0 CommerCial
.%l......jOS.SITE:.INFORMATION,.ANOiJL'OCATIONJ.....:, .
Job site address:
City:
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).
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Signing supervisor's license no.: 34'0';<8,
Print name of signing supervisor:
Signature of signing supervisor.
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NOTICE: . .. THE WORK
THIS PERMIT SHAll EXPlRE IF T:0
AUTHORIZED UNDER THIS PERMIT IS NO\\~~
COMMENCED OR IS ABANDONED FOR,' \ Q
ANY 180 DAY PERIOD. ~.\~.,:&
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440-2584-J (9/08/COM) ~
:.>>:...... '.:' ,....:' '::FEE:SCHEDULE- :--::.:',:." '
':,-',,,,. "'Qt:" I 'Cost.'I'.'Total
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Residential, per unit, sen'ice included:
t,OOO 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, alteration, relocation
200 amps or less (2) ;Z $ 81.00 $ I&> z.
20 I to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to t,OOO amps (2) $205.00 $
Over 1,000 amps Or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary sen'ices or feeders: installation, alteration, relocation
200 amps or less (2)
20 Ito 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, alterq!'E..n, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I D I $ 6.00 $ Gn
b. Fee for branch circuits ~itho.ut purchase of a service or feeder fee:
First branch circuit (2) . i,-OS (0$ .~~:90 $
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Each addition_al b}-'Wg~\~~uit- .l_ . r ie90"\ _$~ ;~,~!h $
MAl.. 11-.;"'''\''-' 11';''!.', ,-.4 DX 1..'/- ....,.-::. :-,;;:... ...
'''-'f1Cf. e-neo~s_ ~e~:\-fi~iceo~r !.e,!fje{l.n.Qt:in.cL<<4q5!.?~oO \-
E~'p~M~1.~r0iz~tic)n'?~~~c)~~~ioU9\l ~::~ e$l63ilO'J' $
EWii'}\~~<[ujlill\\lllgl(t/\I!h(~ CO\l:~: ,p, tE \E$!6~9.9,r $
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51 i'!&r\,U""'F,~ hl1))g:,,\91ergy panel,i' \t~ \' .$ 6300
alt i6n;lWi~xtensiOli\Il::\regO(\ un' ,.?3/4). .
Each i\~d,W.OiiOl\~!p:C' i~lI:'(ig,\lV'v- $58.00
$
$
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(A) Enter subtotal of above f~es
(Minimum Permit Fee $58.00)
(8) Enter t2% surcharge (.12 x [A])
(C) Technology Fee (5% of[AD
TOTAL rees and surcharges (A through C):
$;(() :z
$ .J.6,1fI
$ i {. 10
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.,.,~ OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00418
3520 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permilcenter@ci,springfield.or.us
RECEIPT NO: 2010000715
RECORD NO: 8II-SPR20IO-004I8
DATE: 11/01/2010
IbES" CBIPTIO_ N',','," ,-" - ~-- H", ,se,'. ,T'.;_'\_ nT' Accbl)NTr'C'ODE".',/'.., ,:AMOlJNT DUE "; ,5' , J
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Services 200 amps or less '224-00000-426102 $162,00
Branch circuits with service or feeder each circuit 224-00000-426102 $60.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $26.64
Technology fee (5% of permit total) 100-00000-425605 $11.10
TOTAL DUE: $259.74
t . PAYMENt,TYPE'-t':,!PAY6R_~~s8IER:bB-oWlsi3'if'-,_;.c6MMENIt1-'-'~' :"f,;.. _ ;~~Mb!JNT~PAID--" '",'.. " '. 1
Check
33364
LANTZ ELECTRIC INC
$259.74
$259.74