HomeMy WebLinkAboutPermit Electrical 2010-11-16
Electrical Permit Application
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'CITy;.oErSPRlNGEIELn;, OREGON' ':
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225 Fifth St"c!.Springfield, OR 97477tPlI(541)726-3753tFAX(541)726-3689
DEPARTMENT USE .ONLY
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Permit no.:
Date: //~/b-/O
This permit is issned nnder OAR 918-309-0000, Permits are nontransferable. Permits expire if work is not started within 180
days of issnance or if work is snspended for 180 days.
'. LOCALGOVERNMEIIITAPPROVAL ..,'
Zoning approval verified? 0 Yes D No
I'" " CATEGORY OF CONSTRUCTION'
~ Residential I D Government I D Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 3227 Partridge SI.
City: Springfield I State: OR I ZIP: 97477
Reference:1703 Z '2-1" I Taxlot:QbbDO
. ~' J DESCRIPJIOt{OJ;,WORK. ',.
Re- Wire Kitchen
.' ,:":'.PRQP.ERTY.:OWNER ,0 -:,,:":,'"
Name: John Williams
Address: 3227 Partridge SI.
City: Springfield
I State: OR
I Fax:
I ZIP: 97477
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
479540(1) and 479,560(1),
Signature:
CONTRACTOR INSTALLATION ,
Business name: Contractors Electric, LLC
Address: 4224 West 7th Ave. #1
City: Eugene I State: OR I ZIP: 97402
Phone: 541-343-2222 I Fax: 541-344-0155
E-mail: pennits@ContractorsElectricLLC.com
CCB license no,: 190503 I BCD license no,: C611
Signing supervisor's license no.: 52515
Print name of signing supervisor: Jeff Brown
. . FEE SCHEDULE
Number-of inspections per item () Qty. Cost Total
ea. cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134,00 $ 0.00
Each additional 500 sq. ft. or portion $ 25.00 $ 0,00
thereof
Limited energy (2) $ 32,00 $ 0.00
Each manufactured home or modular $ 63,00 $ 0.00
dwelling service or feeder (2) Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $ 0,00
201 to 400 amps (2) $ 95,00 $ 0.00
401 to 600 amps (2) $158,00 $ 0.00
601 to 1,000 amps (2) $205.00 $ 0.00
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63,00 $ 0.00
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63,00 $ 0,00
20 I to 400 amps (2) $ 87,00 $ 0,00
401 to 600 amps (2) $126,00 $ 0,00
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 ofa service or feeder fee:
Each branch circuit I $ 6,00 $ 0,00
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) 1 $ 55.00 $ 55,00
Each additional branch circuit 2 $ 6,00 $ 12.00
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $ 0.00
Each sign or outline lighting (2) $ 63,00 $ 0,00
Signal circuit or a limited-energy panel, $ 63,00 $ 0.00
alteration, or extension (2)
Each additional inspection: (1) $58,00 $ 0,00
APPLICANT USE
(A) Enter subtotal of above fees $67.00
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (12 x [AD $8.04
I:LC:) Technology Fee (5% of [AD $3.35
Im;nif,\lf)f~~f~'\!1'!)!fr~l!1!riles1<i1illij,bj)gJi(C): $78.39
Signature of signing supervisor: (1p /J____ ~
v-'fIJ.-. . .
1111~
ATTENTION: Oregon I~llres you to ("\
follow rules adopted by the Oregon Utility \ ('\~~.'v
Notification Center. Those rules are set forth \J" ~I\J
in OAR 952-001-0010 through OAR 952-001- ~
0090. You may obtain copies of the rules by NOTlI
calling the center. (Note: the telephone ~
number for the Oregon Utility Notification -:?u. TH IS F
Center is 1-800-332-2344). '\J" AUTHORIZED UNDER THIS PERMIT IS NDT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
440-2584-J (9!08/COM)
. .
www.ci.sprlngfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00719
3227 PARTRIDGE WAY
CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541-726~3753
RECEIPT NO: 201000083 I
permitcenter@ci.springfield.or.us
RECORD NO: 811-SPR20I0-00719
DATE: 11/16/2010
lQ.I;.SCBJETIO/ll; "''T--T-",_ T~O .'_,~~. ,,,;',
Branch circuits with service or feeder each circuit
Branch circuits without service or feeder - 1 st circuit
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P..C,C,OLJtoj'(C90E " ""'.~-~MQUND~,liE'
224-00000-426102 $12.00
224-00000-426102 $55.00
821-00000-215004 $8,04
1 00-00000-425605 $3.35
TOTAL DUE: $78,39
:(6MMl;.t.tl$~:E;--..,)~: . ,",' ~::AMOUN:r.PAID, "-, .- "
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State of Oregon Surcharge (12% of applicable fees)
Techn~o,.~y fee (5% of permit total)
VA?AYiII!ENT TYPE'''' ,':"',PA'tOR..i..;.; CA$HIERfDE30Vv'SB~--
On' '....~!d:!::...M' "
Credit Card
016871
CONTRACTORS ELECTRIC
LLC
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$78.39
$78.39
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