HomeMy WebLinkAboutPermit Electrical 2010-10-1
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or' -. '.,.
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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(h:(iJ,'tDEPARTMENT"uSEioNT.v ,
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Permit 9~ . 0 0 'pr
no.
Date: IIJ - I-I 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.
,!I!;OCAtGOVERNMENlAPPROVAt/": ", ~
Zoning approval verified? 0 Yes 0 No
":i'~;,:;"i1:."CAlEGOR~;OF;C()NSTRl.JCTION..
o Residential ~ Government 0 Commercial
':'fJOB,;;SI]E,INFORMATIQNAND, :tiO.CATIONIL:::' :~:t:
Job site address: '-lW CO'(/.Y!f" IX
City: 3 'ZO State:
170
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).
Signature:
....: 'CONTRACTOR'INSTAtitATION<'
Phone: --
E-mail:
CCB license no.:
~(j.sz:s(....
Signature of signing supervisor.
NOTICE: . ,.', "i "'co"~ ~~ ~
THIS PERMIT SHALL EXPIRE IF THE WORK ~\';
AUTHORIZED UNDER THIS PERMIT IS NOT '\1t\:.
COMMENCED OR IS ABANDONED FOR .,:' \,
ANY 180 DAY PERIOD. .
~
440-2584-) (9/0B/COM)
I~+'" :/'," '. 'FEE:ltSCHEDULE:; '. ; ,0','
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"~-h', "':; ... \I~; "ICost'; I ;Total
,; +"':;"ea,.' ; cost ,;
Residential, per unit, service included:
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, alteration, relocation
200 amps or less (2) , $ 81.00 $RJ
20 I to 400 amps (2) $ 95.00 $
40 I 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 $
Temponry services or feeders: installation, alteration. relocation
200 amps or less (2) -~ $ 63.00 $
201 to 400 amps (2) $ 87.00 $
40 I 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 ~ $ 6.00 $/2-
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ . ~.OO $
Miscellaneous fees: ~rgiPln?rf~.r4et:t1oJNiJ~ud.~~\ti\itV
E'41ip1ffi~ldr:~;aYR'i~iWllo [2j tn~". 11";"'0::) , iSo6:l>OO:r $
o ~r ,"'.... -
Eal!il\!?&1)Si\8;'~~'ejill1\lr"gxU':'~:,: or OAf r$J 63~~~ $
, "
SltW.tfinFi:i~!ie.(i{;\'1f~:'t~\w..ap~- 01ltl~:u'v $
alt ,il!)lwrem!J1J1 ~ "'~'O' 1 ,e tE \~$,.J~3l0tll
.. 1-......
Ea~~Mili1'.~:iJ1~spml>~j,<I')o~ Uti! ,tv _~ ;;"$58:00 $
.:.,~ :l?cPE.t~;J.\l8'se"':".>- . . ..
toY.?: ')V
(A) Enter subto a of above fees q ,
(Minimum Permit Fee $58.00) $ 3
(8) Enter 12% surcharge (.12 x [A]) $ I/./ (.,
(C) Technology Fec (5% of[A]) $ '1,(,S
TOTAL fees and surcharges (A through C): $ ftJZii I
.
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00415
3620 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth 8t
Springfield,OR 97477
541-726-3753
pe rmitcenter@ci.springfield.or.us
RECEIPT NO: 2010000714
RECORD NO: 811-SPR2010-00415 DATE: 11/01/2010
: -_~.".''JC::;-,; -,,.:~;;,,,,_!: =_':;").C.C.oUNJcCODE -'''7%~,_;'::=.6.IVI()_U.N:(Dl.JL...::.:..;''':'__ J
224-00000-426102 $8100
224-00000-426102 $12,00
821-00000-215004 $11,16
100-00000-425605 $4,65
TOTAL DUE: $108.81
h:p A '{MEN" :T~PI;:'r,'; PAYOR: ",1 -cAs8IER.De0WLSB.'iY:;''1?CQMiYiE;)ljis:r;~ ",'I;;!};';""'''''', ;'\,:,: k:.6.M()l!)ljn"AID"
Lpi::S.<<BlfJlQf:t 1'J~;:',::":: .,:
Services 200 amps or less
Branch circuits with service or feeder each circuit
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
-:1
Check
33364
LANTZ ELECTRIC INC
$108.81
$108,81