Loading...
HomeMy WebLinkAboutPermit Electrical 2010-11-16 ; .'" 225 Fifth Street. Springfield, OR 97477 +PH(541)726-3753 +FAX(541)726-3689 "- DEPARTMENt USE ONLY. ,,' ~ . ' . 5PfL Z.O(~- 0 f::; 72 L Permit no.. . Date: /(-/6 -(0 ~ p~-* S f(L 'd-O/d-6C:}o"3 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 ,~I :;, ".-:':"Cl'T.EGbRYJOF'_:'.CQNSTRUC_:rIQN'~;,;';f . ,-' D Residential D Government !5l Commercial r?~1!{1i.';~,OB;~SITE';'INF:ORIIiIATI:ON!;ANI5MEO~A"'10N;:*,; i)';i'H 3') S- A'\e w 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. ~ City: Phone: E-mail: Signing supervisor's license no.: Print- name of signing supervisor: Signature of signing supervisor: tfS' . Y' to 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) . Z- ~l,:,i/":",";;'~?Hff'1~,,?:;~;<:~:~{~~j/:;';:::~'~'6E:~ii;',SCHEb]JI3E:g.~;~}W"';,;i;0jt~}Y:R~~~~~%~Ej~ ,Number' of;inspectlo'ns',per item' (.) , . i' Qty. Cost Total " ':_ _' '", '-("'_' ,:."' '. '-:,/:. ;'-," '''- .,', to.' -' , _"~'-" i''-~~.:' f.:~_st: l., 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 $ - '::>:,' (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. 7' - .1 ~ 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 A ,~:::::;-~;",~ "~;,:~~V;:/'t~,;~S,',l,'~l::t.o.li(Nf~cj:>[)E;;",,S';-_ ~',-'~e:Mo.UN;r~Q.Ug~-:",' -S', -j 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',":;;:: . ~"~--_.., "'" 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