HomeMy WebLinkAboutPermit Electrical 2010-11-16
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Electrical Permit Application
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CITY OF SPRINGFIELD, OREGON
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DEPARTMENT USE ONLY
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Permit no.:
225 Fifth Streett Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689
Date: - b' (U
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissuance or if work is suspended for 180 days.
FEE SCHEDULE
N umber of inspections per item ( ) Qty. Cost Total
ea. cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) S 134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 S
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) S 81.00 $
20 I to 400 amps (2) S 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 $
Temporary services or feeders: installation, alteration. relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
40 I 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. Fec for branch circuits with purchase 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 branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service orfeeder no! included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) / $ 63.00 $//13.
Signal circuit or a limited-energy panel, $ 63.00 S
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees S 03
(Minimum Permit Fec $58.00)
(B) Enter 12% surcharge (.12 x,[A]) $ :7.S"c,
(e) Tcchnolfg)Cf,rM~1:'> flflMF WORK $ 3./S
IVI.!!::1~nf,cf} m~~'i$NilII\'f(.f.St~Hi),gh C): $?3.7f
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LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
o Government
Commercial
Phone:
E-mail:
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:
Print name of signing supervisor:
Signature of signing supervisor
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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 NOTICE:
calling the center. (Note: the telephone THIS PER
number for the Oregon Utility Notification AUTHORI
Center is 1-800-332-2344). ~ COMMENCED OR IS ABANDONED FOR
440-2584-J 19/08/cm.l) ~~ '\:. . ANY 180 DAY PERIOD.
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~ OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00718
3000 GATEWAY ST SPACE
418
CITY OF SPRINGFIELD
225 Fifth 51
Springfield, OR 97477
541.726-3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 2010000837
RECORD NO: 81 I-SPR2010.00718
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224-00000-426102
100.00000-425605
821-00000.215004
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TOTAL DUE:
DATE: 11/16/2010
rQ!;~IllP.l!QN._' .
Sign or outline Ii~htin~
Technol~gy..!ee(~% q!,permit total)
State of Oregon Surcharge (12% of applicable fees)
';'.i, ~MOjJ~J.DIj'E';.~.::.....~- ..:]
. $63.00
$3.15
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$7.56
$73.71
'" ..' .'~MOt:JNT:PAID' .' .;.: : .-.'.1
t- ,i>AVME'IiIJYPE ':' ':I!A VOR"." -cAsHIEIF6BQWL~j;_OMIVIENiTS" p.,
Credit Card
016984
es & a sign corp
$73.71
$73.71