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HomeMy WebLinkAboutPermit Electrical 2010-12-8 Ele~~l Permit Application :crhfoE.S~RINGFIELD"' OREGON!,:- "~'l:-:I.,-' '...- :.~---j,~ .-~ "'- }'t"':~'Il~ ~, '1'#" t!_~..'l"I"~'''.,",,-->> "''}<. ""1"\.7.,,-- 225 Fifth Streett Springfield, OR 97477.PH(541)726-3753tFAX(541)726-3689 .' '.~' DEPNUMENT USE ONLY .5/0-00 bg7 Penmt no.: Date: /7 - ~-/O This permit is issued under OAR 918-309-0000. Permits are nontrausferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. . 'LOCAL: GOVERNMENT APPROVA.l"",' Zoning approval verified? DYes D No '. "CA.TEGORY:OF~CONSTRUCTION!i.' ,'i.: esidential 0 Government 0 Commercial i~~2l-'&;j~OEl'j:SITE "IN FORNiA:;rJQNI:ANbG'EQCA.'rIO Job site address: "Z- -, 0 s.. . 5 Z... City: S '?F State: olL ZIP: 7' 7l(~ Reference: 170 Z. '3 '3 Taxlot.:OZooc:::. DESCRIPTION OF WORK':" . ", St:Ytl/lc..kr UfA-,vw Z C.l./LIAI PROPERl'Y OWNER ~~ c..c::y< Z-7D S. 52'" SF'I-i). Name: Address: City: Phone: E-mail: This installation is being made on residential or fann 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). ~+- ZIP:?7C(7g Signature: ~\ Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: NOTICE: ~~~~,,~ THIS PERMIT SHAll EXPIRE IF ~W\~~~~ . AUTHORlZED UNDER THIS PER COMMENCED OR IS ABANDONED FOR ",' ANY 180 DAY PERIOD. ".'~:'i,':.%~J:r~tnY'1J!~?J::~j:t?r~EEE:-;~1SCH E_OO-[jEt:::-i,:i'QD~'~,!~i!;{Wi~~~~~~;:~~~~'!#%}9~ . . ",,' '.' "" Clist Total ,.N:~~~~~' ~.f.:.in,spe~t~~.'~~ P;~!" ,it~,~;' (.):, Q'ty. ,,, ~a~ . cost Residential, per unit, service included: 1,000 sq: ft. or les;(4) $134.00 $ Each additional 500 sq. ft, or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ $ dwelling service or feeder (2) 63.00 Services or feeders: installation, alteration, relocation 200 amps or less (2) / $ 81.00 $6/ 201 to 400 amps (2) $ 95.00 $ 401 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: installation, 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 $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch Circuit (2) $ 55.00 $ Each additional branch circuit L $ 6.00 $/ Z. Miscellaneous fees: service or feeder ~ot included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (1) $58.00 $ :'~'i~1,7-;:Ah}0&Sif~r~~~Yt.~1;~j-~;~~tARe:I1Tc-A'NT~:;US_E~?';,~:i';"~:E;:;~:,~(:;X(,~~j~; '''. '~~-:' .',' ','. .,~ -, . . ,,,:;,;',,':;: I(A~J:llilter!.lgbtQ\ll'\Of@.~~~ifEerOU to $ 93 l h(1\iinjri1.umCPer,niiH.e$S~'OQ)tJ\ility I.' ':cllj,$HI&' W%' ~J'r~HU r'61'l2:~1~Jrirm $ /I 1(" !. _, I _'.11 lth.,..."M~, \1\1-11 _ ,--I JG9h1jegLn!I.!Hgx:B~r~o/;Pflt~]~ules bv $ L{ :.) rIfO:f.Ni\1fee~l\\n\t1s,jFc'h1frgesf~A:rtlJrough C): $JtJ ~ gl ~ -., ,...... ,. . ".... .. .." .' 'VI LII\':'; \J''''8V'. UlIlUY ''lVLIlI\JQLlVI ATTEN follow r Notilical in OAR 9 0090. Yo calling number Center is 1-800-332-2344). 440-2584-J (9108/COM) . ..... S~~:~~E~ L~ ~OREGON www.cLspringfield.or.us TRANSACTION RECEIPT 811-SPR2010-00687 270 S 52ND ST CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726-3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2010000999 RECORD NO: 811-SPR20JO-00687 DATE: 12/08/2010 State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) ';"<- "ACCOUNI'CODE':~'0 -/, .' ._.'~-- ~..~_.,", 224-00000-426102 224-00000-426102 821-00000-215004 100-00000-425605 TOTAL DUE: -iC9Mjlnt~tS;-, :-':' ",', "",. , KMQl!~Jj)JiI':-' " $81,00 $1200 $11,16 $4,65 $108,81 -AM(tU_NT ~.6.~_ . I IDESCRip,TION,'" :;..~_'(..,i{..' ,-..;-;,,..-:-=.... :;n-'-'!F~ Services 200 amps or less Branch circuits with service or feeder each circuit L PAYM.~!::!.TT(PE'" -PAVOR:y"'-Ci\sHIER,bsoV\j:sBY',;' Credit Card 009004 wayne antone electrical $108,81 $108,81