HomeMy WebLinkAboutPermit Electrical 2010-10-1
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Electrical Permit Ap
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225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
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. Permit no.: 5/0. 00 t:-
Date: ./-, 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.
. . .'tOCAl'~GOVERNMENT Ai>PROVAl. . jL <0 ~
Zoning approval verified? DYes D No
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This installation is being made on residential or fann 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:
~'l'?,]]'~~]]]?CONTRACTOR~INSTAl.l:.ATION .
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E-mail:
CCB license no.:
BCD license no.:2iJ
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Signing supervisor's license no.:
Print name of signing supervisor:l1"vY}
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Signature of signing supervisor.
NOTICE:' .... "',,;t~.l'~.i;;"'~;<"
THIS PERMIT SHAll EXPIRE IF THE WORK ~
AUTHORIZED UNDER THIS PERMIT IS NOT" \ \
COMMENCED OR IS ABANDONED FOR d~y'\ I\)
ANY 1Sa DAY PERIOD. ,~., ' \\\\0'\
440.2584.J(9108/COM) .~ ~Ta~
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" ,.FEE.SCHEDUlE
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Cost
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Total
cost p
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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)
Senrices or feeders: installation, alteration, relocation
200 amps or less (2)
20 I to 400 amps (2)
401 to 600 amps (2)
601 to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
:1 $ 81.00
$ 95.00
$158.00
$205.00
$469.00
$ 63.00
$1 &i2.
$
$
$
$
$
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
20 I 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, exten..sion per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit :z. $ 6.00 I $ J 2-
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) .... 1t;>\M I 8au\I'e~$ ':55~~~: $
Eaclp{ilfdill~~I!\,}:i!,Eit~~'Qj'ijbV th 3 Or ,g$~6~~~~ ;;~
M iscellil~~'UN~~i (eciif.~~r fi~de;: ~JN~!:!4./#'d' Q52 -00 i .
Each_iJ;~t1iiiJanGh1!2)1I~~n ~~ 0 \~.$310b3. r$V
Each ~.fij,oMllIHig\\\{.~~'!l)" INotE: thE i$\%.~.~~;I,~~
Signalci"'ilil\\}(H~'i1'1~il:enegy,I?)lililI, It\lllY ''''~~~'o~'' $
alteratIol'\lS'~t<iiiSlO\\ fZ), <.ROO" 32.2~'r'T .
Each additional iirSpection: (I) $58.00 $
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.
(A) Enter subtotal of above fees
(Minimum Permit Fee "$58.00)
(B) Enter 12% surcharge (.12 x [A])
(e) Technology Fee (5% of [A])
TOTAL fees and surcharges (A through C):
.
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$ 1/'1&
$~
$~
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00416
3350 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth 51
Springfleld,OR 97477
541-726-3753
perm ilcenler@ci.springfield,or,us
RECEIPT NO: 2010000713
RECOIlD NO: 811-SPR2010-00416 DATE: 11/01/2010
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224-00000-426102 $162,00
224-00000-426102 $12,00
821-00000-215004 $20,88
100-00000-425605 $8.70
TOTAL ~UE: $203,58
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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
$203,58
$203,58