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HomeMy WebLinkAboutPermit Electrical 2010-11-16 Electrical Permit Application . ~ <'>< ~ ~ " ,." , . 'CITy;.oErSPRlNGEIELn;, OREGON' ': J , "'1: "%"''\''$'' ". " 225 Fifth St"c!.Springfield, OR 97477tPlI(541)726-3753tFAX(541)726-3689 DEPARTMENT USE .ONLY - ".~'..,i -. .... ...... ~.".. .,'- ", "', .,- Slll-Wl0 - 0 0 7/7 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 ;"" 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, "-, .- " ,.,.~ , 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 r '- $78.39 $78.39 1 w