HomeMy WebLinkAboutPermit Electrical 2010-12-8
Ele~~l Permit Application
:crhfoE.S~RINGFIELD"' OREGON!,:-
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225 Fifth Streett Springfield, OR 97477.PH(541)726-3753tFAX(541)726-3689
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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).
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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
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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