HomeMy WebLinkAboutPermit Electrical 2010-11-2
225 Fifth Street. Springfield, OR 97477+PH(541)726-3753tFAX(54 1)726-3689
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DEPARTMENT USE ONLY
S'tLZOIO p OO']IS
Permit no.:
Date: ' 2-10
Tbis permit is issued under OAR 918-309-0000. Permits are nootransferable. Permits expire if work is nol started witbin 180
days of issuance or if work is suspended for 180 days;
NOTICE
THIS PE
AUTHOR
COMME
ANY 180 DAY PERIOD.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? DYes D No
CATEGORY OF CONSTRUCTION
Reference:
hO
Name:
, -
City: ,..c'.rc G
Phone: (-1X- fE'lL{
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate fami ly. This '
property is not intended for s , exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
Business name:
Address:
City:
ZIP:
Phone:
E-mail:
CCB license no.:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344). '
440-2584-J (9108/COM) .
FEE SCHEDULE
Number of inspections per item () Qty. Cost Total
ea. cost
Residential, per unit, service included:
t ,000 sq, ft. or tess (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular I $ 63.00 $63
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 arnps (2) $ 95.00 $
40 I to 600 amps (2) $158.00 $
60 I to 1,000 amps (2) $205.00 $
Over t.OOO amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 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 I $ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55,00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees $ b'1
(Minimum Permit Fee $58.00)
. ~. - ,..._.....I>~....-'-._". 7Sb-
(B)EnterI2%surcharge(.t2x[AJ) , $
F r(tlr-~WM1tg~. !1- VVUh~ .' $3/f
I J u e ~'tJ~ghC): $ '7"7?'
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~OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00315
463 S 46TH ST
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
permilcenter@ci.springfield.or.us
RECEIPT NO, 20 I 0000727
RECORD NO, 81 I-SPR20JO-003I5
DATE: 11/02/2010
~~~~_c9Jj'~itiCJ;JQ~'" :;"';~~AMQ.Q~mR.U_E'- _~
224-00000-426102 $63.00
821-00000-215004 $7.56
100-00000-425605 $3.15
TOTAL DUE: $73.71
LP.~,(MENT_TYPE;cS;;;;;e&y_O_~LI;CAS~IER:'DBbw'ili.J :-rCOMMEM'si.~:::Z;~:";; ':':J...G;.!:i~AM.QlJ.tllJ:AlR:_~",..:.c-,-:.-J
[PESCRIPTION"'" .::;.fSi::f\" c_' d.?ti-.,',., ":. \. .t.:f.;;E,,"'~J:(
Ea manufactured or modular dwelling, se~~ce, feeder
State of Oregon Surcharge, (12% of applicable fees)
Tec~nology fe!, (5% of permit tol~
Credit Card
465567
Bradly Anderson
$73.71
$73.71