HomeMy WebLinkAboutPermit Miscellaneous 2010-11-19
Date:
This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is Jt started within 180
days of issuance or if work is suspended for 180 days. . II
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225 Fifth Street. Springfield, OR 97477 tPH(541)726-3753 +FAX(541)726-3689
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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:
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,
Phone' -
E-mail:
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervis
Signature of signing supervisor
BCD license no.:
"')TICE:
'. '1i=RMIT SHALL EXF'Ii;~ i, "~J.<~'\t-\D
~~f) UNDER THIS PERMIT I~\VV
. ~q 1S ABANDONED FO~F
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440-2584-J (9/08/COM)
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, Di:P.jl.RTMENT USE ONLY
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Permit no. ;;)0 - '1 Jtf
II (\ \ -2":>- D)
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'~~':?;">'H1:f:1~E~-tl;~0~~t'~%~~11!f~:T<'~.E-~'~~\S'CH E.pJJ'~Elij{!~~~~:~f0i(:f~if~"t~R~",7;~t1n
. .' ...,. """."" Cost Total
;Num~~r ?fin;pedion,sper~t~'1' P.i' Qiy. ..;. 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, aLte~atjon,l!reLocatjon
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95.00 $
40 I '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: installatio .,' aLteration, reLocation
200 amps or less (2) I $ 63,00 $b3
201 to 400 amps (2) 'I $ 87.00 $
401 10600 ap)p~'(?)1TI0N: Oregon \; ,wJe 1"i..r.!.S HO 1'0
. I _ $126.00, ",$...
Over 600 affip~ 'OF"l ;06'0-:'Yoits:~~I~~&i6~S lb~l:"fe'e'cier~l~e~tio~:atiove
.. ...." ," .~ro.__..._.. ,hn~n'frll'"''''i'''l!r-::'->\:i.t,u'~11
1'\1\."111.....<.\\.....,' ""~"'_.'.. ,
Branch cirspit~i..1!-f':":'.:H!f~re~io!Jce~!e.rj.s.io_n ps'r,paneli 95~-O~1-
a. Fee for branch circuits'with plirchase~6failtsdrvTce\orfeedeFfee:
"'---" . . ,..~~..L ,.__.... +,...,!nnhnnp-
Each brancF~Ut~R t~~~ ~h~~'~~~~6~'1 i"U~,; ("; ~-~L6...00;; ..i$ n
b. Fee for bniiich' drc0,t~I~l.ig~oJ.lJ pu~chase:9.f~a's&vice.or feeder fee:
First branch circuit (2) II $ 55.00 $
Each additional branch circuit il $ 6.00 $
Miscellaneous fees: service or feeder f!ot in~Luded
Each pump or irrigation ~ircle (2) :1 $ 63.00 $
Each sign or outline lighting (2) II $ 63.00 $
Signal circuit or a limited-energy pan~l, II $ 63,00 $ ,
alteration, or extension (2)
Each additional inspection: (1) 11 $58.00 $
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(A) Enter subtotal of above fees UJ
(Minimum Permi.! Fee $58.00) $
(B) Enter 12% surcharge (.12 x [AD $ fJ~
(e) Technology Fee (5% of[AD $ ,l"~
TOTAL fees and surcharges (A through C): $ 7??[
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Sr~INGFIE.~
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00758
5703 MAIN ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permilcenter@cj,springfield,or,us
RECEIPT NO: 2010000908
RECORD NO: 81 I-SPR201O-00758
DATE: 11/23/2010
rbESCR-ipTjON;:;/";-"".--~--.' -...'-.-__ , '" ,_, ,'-
Temp services 200 amps or less
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable feesf
"-c. "..:ACJ;_QU~NT:.GJ:)QE,Jt0\c~{," - .<l
224-00000-426102
100-00000-425605
821-00000-215004
TOTAL DUE:
, ;-:1\!'viQ:U}lJ.:'.Q.UJ:~
$63.00
$3.15
$7.56
$73.71
ANto'yNI.PAID'
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I"'..PA'fM~.J TYE.I;-, ~;,j'AiQR :;-"CASHIER'-NMACHADo-.'~~;c_6iv1MENrs?' .'-'-
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Credit Card
07356C .
BEAU LEACH
$73.71
$73.71