HomeMy WebLinkAboutPermit Electrical 2010-11-16
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225 Fifth Street. Springfield, OR 97477 +PH(541)726-3753 +FAX(541)726-3689
"- DEPARTMENt USE ONLY.
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5PfL Z.O(~- 0 f::; 72 L
Permit no.. .
Date: /(-/6 -(0
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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.
'.EOCALGOVERNIIiIENT"'AP.PROVAL",o,:'{c\",;.
Zoning approval verified? 0 Yes 0 No
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D Residential D Government !5l Commercial
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Name:
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 INSTALLATION.
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City:
Phone:
E-mail:
Signing supervisor's license no.:
Print- name of signing supervisor:
Signature of signing supervisor:
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ATTENTION: Oregon I requlre~n Utility
folloW rules adopted by the o~eire set forth
Notification Center. Those ru~eOAR 952-001-
in OAR 952-00~ ~~~~i~S of the rules by
0090. You ma9'15i'!f~ (Note' the telephone
calling the center. uiilityNotification
llumber for the. Oregoll_332_2344). .
Center IS 1-800
440-2584-) (9/08/COM)
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,Number' of;inspectlo'ns',per item' (.) , . i' Qty. Cost Total
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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)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) II. $ 95.00 $ftjo <l'
401 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 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
20] to 400 amps (2) $ 87.00 $
40] 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 $ljqk"
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 ':lot 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 $
alter8;tion, or extension (2)
Each additional inspection: (1) $58.00 $
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(A) Enter subtotal of above fees $hr('"
(Minimum Permit Fee $58.00)
(ll~frW.12.% surcharge (.12 x [AD P, ~;.:~ "li;;-?;: "w $ 82S ~
(~)~ti:~~w.rfel<,(~1(~a[~))?lRE IF THE \I\I~~~ $, slj'P
ti?,i;':'M-lf~~sla8<\.!p:~mgeW\\ fhli . ,llu I $R.O"
BfiNDUNttTru.. ~":".
COMMENCED OR IS A
ANY 180 DAY PERIOD.
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00722
3375 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
"
permitcenter@cLspringfield.or.us
RECOIW NO: 81 ]-SPR20]0-00722 DATE: 11/16/2010
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224-00000-426102 $190.00
224-00000-426102 $498.00
821-00000-215004 $82.56
100-00000-425605 $34.40
TOTAL DUE: $804.96
VPAYIVfENT,Ty:j:>E~"'. 'PAYORsr"GAS'HIER DBOWcSBy~i.'Tc:QI'I!ME.r'!tS;::'iiJ C..'i";5:";": -;~ :sAtvlQ!,(NT PAl!>' ',2.~
RECEIPT NO: 20]0000839
[DESCRIPTiON:" .y',":;;::
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Services 201 to 400 amps
Branch circuits with service or feeder each circuit
State of Oregon Surcharge (12% of applicable fees)
~l1nolog~ fee (5% of p~mit !~"'}___
Credit Card
,016877
BOYLES ELECTRIC INC
$804.96
$804.96