HomeMy WebLinkAboutPermit Electrical 2010-11-30
225 Fifth Street+Springfield. OR 97477+PH(541)726.3753+FAX(541)726-3689
,. 'D~~;BT",,!~in USE ONLY
Permit no.: SIO -00 7 q 7
Date: - :! 0 -I 0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissu.ance or if work is suspended for 180 days.
CCB license no.: 5
Signing supervisor's license no.:
Print name of signing superviso
Signature of signing supervisor:
. s you to
ATTENTION: Oregon law .et1~lre l'" Y
follow rules adopted by "J ~~ea~~~et f~~th
Notification Center. Those ru~ OAR 952-001-
in OAR 952-001-~~t~~~h;~~i~S of the rules by ,
0090. You may N te' the telephone ~S.l
calling tfhe tChen~;'eg(o~ Uiility Notification .l\ J,\i
number or e 2344) ~l
Center is 1-800-332- . . ~
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440-2584-J (9/08/COM) 10NM 3Hl:l\ 3\:11dX3 11l1HS 1l\fll\:l3d SIHl
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ZIP: '?1I '7"7
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:
~:::';'i,;J~l:'-y'jCONTAACTOR.iINST ALLA TION'/!i/1;",
I."~;' " "Z:.fEEISCHEDULE ""','
'">;'\"f"'\-"fi,:~:~'~~~~.":f"~',>-';;!.i'"",~;' "",. ~)' ~'<~: "'li/f.f '\'.' " ..-, .Cost Total
_ ~.~.,!t~~t'~.f'.insp~'~Hon.~_'pe'rlte~'(), "Q~y:; ea. cost
~". ,~.......,._._.,....."..,f,..;.. . ..",' "', ...".,.'.." .\."~ .'.,".""' ,. -"- . ,.,
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additiona1500 sq, ft. or portion $ 25.00 $
thereof
Limited energy (2) i $ 32.00 $'.
(
Each manufactured home or modu lar $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 a~ps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Ovcr 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: iYfstallation, alteration, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 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. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I I $ 6.00 $
b. Fee for branch circuits without purchase ofa service of fceder fee:
First branch circuit (2) / $ 55.00 $Sr
Each additional branch circuit 'ZC $ 6.00 $ I7..C
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, I $ 63.00 $'3
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
*~l!fj~~~~~}~~~B~tARR'lljCA-Nt~f;U_SE'I~"'mt~i~~~$-;~f;}~~~er:\'}
(A) Enter subtotal of above fees $ Z.3~
(Minimum Permit Fee $58.00)
'-
(8) Enter 12% surcharge (.12 x [A]) $ 'z.eS
'-0 ,ti[~'Vn DB ~ I{~t ,
(e) Technology f ANI;( $:
TOTAL feesand 65 Q\\t!J riliigliJ 0): $,Z7$' :t
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, .:X OREGON
www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00797
3443 HUTTON ST
CITY or SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541-726-3753
permilcenter@ci.springfield.or.us
RECEIPT NO: 2010000935
RECORD NO: 81 I.SPR20 1 0.00797
DATE: 11/30/2010
tQI;scRfPTI6'N'.f;.':;;~:rt,'.,::0' ;~:l~~+~'" t, ,_.,i,~r~"s::'t5~ ~\,~,;"
Branch circuits with seNice or feeder each circuit
Branch circuits without service or feeder -1st circuit
Other Limited Ener(!}.
State of Oregon Surcharge (12% of applicable fees)
,. , ~--
Techno,-"gYJ~~j5% of perm~?tal)
" '7;':~C.c.Qi.JN:LC9QEc;,;;F'i:' ~f)~nnQUJIJ...R.O!,F,7;k : ';; 'i]
224-00000A26102 $120.00
224-00000-426102 $55.00
224-00000-426102 $63.00
821-00000-215004 $28.56
100-00000A25605 $11.90
TOTAL DUE: $278.46
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l_'.PAYM.ENl'.'fYPE'+:';'PAYQ~ CASHiER' SSJBA'f if...;'. ,CQM.I\I!!'.NTS ' ; ",F.,
Credit Card
510374
justin paslay
$278.46
$278.46