HomeMy WebLinkAboutPermit Electrical 2010-12-3
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EleCtrical Permit Application
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225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
,- DEPARTMENT USE. ONLy'
SPtl.,O(o.o~'i/ t
Permit no.:
Date: / - -S -/ a
This permit is issued under OAR 9]8-309-0000. Permits are nontransferable. Permits expire if work is not started withi~ ]80
days of issuance or if work is suspended for ]80 days.
":.. '.'
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).
Fax;
Signature:
.CONTRACTOR INSTAllATION.
Business name:
Address;
City:
Phone:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440.-2584-J (9/08/COM)
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., .' Cost Total
.Num~er' ~f.in.spe<:tio'~~Ptlr it~.m'.(.) ." Qly. ;:;~a. , . cost ..
. -. .-. ". - . . ..
Residential, per unit, service included:
1,00.0 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, alteration, relocation
20.0 amps or Jess (2) J $ 81.00 $ 'tl -
20.1 to 40.0 amps (2) j $ 95.00 $~-
40.1 to 60.0. amps (2) $158.00 $
60. I to 1,0.0.0. amps (2) $205.00 $
Over 1,0.00. amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
20.0 amps or less (2) $ 63.00 $
20 I to 40.0 amps (2) $ 87.00 $
40 I 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 $ 6.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder lJot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a Iimited..;energy panel, $ 63.00 $
alteration, Dr,extension (2)
Each additional inspection: (I) $58.00 $
ji:;;!iig~};~i~F;;~,;;i;'!?;*''Ap.J:>,UcANt(:[jSE(i~,':: .;~
(A) Enter subtotal of above fees $ 17~
(Minimum Permit Fee $58.00.) -
(B) Enter 12% surcharge (.12 x [A]) $ 21,11-
(C) Technology Fee (5% of [A]) $ <;:(.W)
TOTAL fees and surcharges (A through C); $ 7;"'~<-t2
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SPA~N~.IEL~
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~OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00818
1408 MAIN ST
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541~726'3753
permitce nter@ci.springfield"or.us
RECEIPT NO: 2010000958
RECORD NO: 811.SPR2010.00818
DATE: 12/03/2010
~Mo.lJIIIT"D.U:E .' ~ :.F ._1
$8100 .
$95.00
$21.12
$8.80
-------
$205.92
AMOUNT PAil)' .h 'i
:-')i.C_c.O.UN:tCOOE'fis,'.- ;:':
224-00000-426102
224-00000-426102
821-00000-215004
100-00000.425605
TOTAL DUE:
":::PA 'iMENT.'T,'YPE:, .;qqPAYOR"";'CASHiER:.OBOWLSBy';~~'+C'OMMENTS; - _,,~ ,'/:-_:;,,,,_.,2'.,:"
L,"" ". _^"~~. ",,'0. ~~. ... ...m .." _. ~.,,__.__.~~ _ .,,___
tDESJ!J:~)ptION>'Y ,;;~'" t -:; i~T,!:: '~~ :;,,-~~-". 7~~t,>$~~~",:',:',''';:>:i';,cX:~J:;;;::'~\'.~;q
Services 200 amps or less
Services 201 to 400 amps
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
Check
13365
LlVEWIRE ELECTRIC INC
$205,92
$205,92