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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 "".' '. .- 225 Fifth Street. Springfield, OR 97477 tPH(541)726-3753 +FAX(541)726-3689 "i;",~'j,.;..,,:-_ 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: " , 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 ''1 .. ~ 0= 440-2584-J (9/08/COM) il . . ;~.'.' i " II ,"., .' . '. , Di:P.jl.RTMENT USE ONLY ." _II Permit no. ;;)0 - '1 Jtf II (\ \ -2":>- D) I '~~':?;">'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 $ ~ " .' (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??[ -' .:-~f. ,c." Sr~INGFIE.~ .~ e ~~~fGON 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' '.' I , I"'..PA'fM~.J TYE.I;-, ~;,j'AiQR :;-"CASHIER'-NMACHADo-.'~~;c_6iv1MENrs?' .'-'- ".........," C'. I ~~ Credit Card 07356C . BEAU LEACH $73.71 $73.71