HomeMy WebLinkAboutPermit Electrical 2010-11-16
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225 Fifth Street. Springfield, OR 97477tPH(541)726-3753tFAX(541)726-3689
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DEP ARTMENt USE ONLY
SfUClO-O C72 3
Pennit no.: .
Date: /1-16'/0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issua.nce or if work is suspended for 180 days.
LOCAL <<;30VERNMENT APPROV At!' .'
Zoning approval verified? D Ves DNa
. CAtEGORY OF CONSTRUCTION
~ Residential D Govemment D Commercial
. :,.'JOB :~mE' INFORMATIoN: AND.LocAtioN.. ...
& 3' 30"i1t
City: t{\"-lGHiZ- - ZIP: 97'178
Reference: 170 L "], Z Taxlot.: /I SO 2-
DESCRIPTION OF WORK
l/t-fDING - W~ $,;/ZVIC-L
Name: D
Address:' 50g
City: " . 6 ('N'L
Phone:
Lt!J1
Fax:
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:
.CONTRACTqR INSTAllATION.
. Business name:
Address:
City:
Phone: l
. Signing supervisor's 'license no.:
Print name of signing supervisor:
Signature of signing supervisor:
. ..'
....:.: . "c.'...:.FEE.SCHE.DUl..E.:.....;...... .. . ;', <- '-"';.'~.;' '~'i"
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..
. '" . .. Cost Total
.Nu~ber of.in,speciio'~s per..item () . Qty. 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 $
201 to 400 amps (2) $ 95.00 $
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 $
Tempor~ry services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
20 I to 400 amps (2) $ 87.00 $
40 J to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, eXJensionper panel
a. Fee for branch circuits with pur~hase of a service or feeder fee:
Each branch circuit , $
$ 6.00
b. Fee for branch circuits without purchase of a service'or feeder fee:
First bra~ch circuit (2) I $ 55.00 $ c;,<;-
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 $
alteration, or .extension (2)
Each additional inspection: (1) $58.00 $
..':./~;;;;~~; ,~!;;:i. AF'I'>l:ICANT 'll 5 E..... ....J~i ;, ...;'
(A) Enter subtotal of above fees $ 5l\ -
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [AD $ ISh
(C) Technology Fee (5'%~f [A]l"'" . $ 2/10
!1rP$~AlfleO'nd~urUialgys WOOl{ugh C): $/,lt50
ED UNDER THI~ ..."",1 J I::; I~U I
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ATTENTION: Oregon law requ: es you to I ~ -P
follow rules adopted by the Oregon Utility \]V'" ~
Notification Center. Those rules are set forth \~.
in OAR 952-001,0010through OAR 952-001-
0090. You may obtain copies of the rules by ~
calling the center. (Note: the telephone
number for the Oregon Utility Nolif/cation. NOTICE:
Center is 1-800-332-2344). THIS PER
AUTHORIZ
COMMENCED OR IS ABANDONED FOR
440-2584-J (9108/COM) ANY 180 DAY PERIOD,
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www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00723
563 35TH ST
CITY OF SPRINGFIELD
225 Fifth 81
Springfield,OR 97477
541~726-3753
permitcenter@cl.springfield.or.us
RECEIPT NO: 2010000841
RECORD NO: 811-SPR2010-0072J
DATE: 11/16/2010
,~h"0Jt 0{. ',AC:C.oUr.(T':'CQ[jEf'%~2L':":,6.MQ_lJNtR.lJlt!;. .-
224-00000-426102 $55.00
...._-~--_._~._._~-~---,--
224-00000-426102 $3.00
821-00000-215004 $6.96
100-00000-425605 $2.90
TOTAL DUE: $67.86
"F' AYr..fEN't'-T;Y;~E,..{ P A'(ORc';j:Y;CASHI€~::bB()VvLS"yr''-;"'"CQJII!JII!!;J!I$:?'-k_~'-;P%5'{{04-'-"',.' . " AMOUNi:iP AID;;:.
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rDE-g'C8!!,.TIQ.N" :_;c~,-::-~.:.{.- ::f.-~ic:.: ':
Branch circuits without service or feeder -1st circuit
Balance of Minimum Electrical Permit Fees
-~..
State of Ore90n Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
-''-''1
Check
13323
L1VEWIRE ELECTRIC INC
$67.86
$67.86