HomeMy WebLinkAboutPermit Electrical 2010-12-6
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225 Fifth Streett Springfield, OR 97477+ PH(541)726-J75J+ FAX(541)726-3689
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Eiectrical Permit Ap
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This permit is issued uuder OAR 918-309-0000. Permits are noutransferable. Permits expire if work is not started within 180
days of issuance or if work is suspeuded for 180 days.
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Zoning approval verified? DYes DNa ".!i""""""~",,,'''.g!$i''"'''''ilii''''(\\P'Il''c.''''''.f'''i '~'n~"[">'t'I~"
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Residential, per unit, service included:
D Residential I D Government 'T~mercial
1,000 sq. ft. or less (4) $134.00
1)1!':~}i.'KrJOBY.si:rE:;IN.F;ORMMION\:"AND;[oCAmforll:t:;;:$';i:~"t~: $
Job site address: 4/.,{; () 111ail? ~\j U?"So Each additional 500 sq. f1. or portion $ 25.00 $
thereof
Citysorr;:J . I Staten (~ ZIP:t11L/ 7 <t Limited energy (2) $ 32.00 $
, Taxlot.: Each manufactured home or modular
Reference: $ 63.00 $
~t~i~:Wfk;~~ii)E;~[)ESCRI~TfONi[OF,;If;.WORK1Wli!lii.'t~ij~~~Jf: dwelling service or feeder (2)
I J11-', I / Services or feeders: installation, alteration, relocation
-,- I "T 200 amps or less (2) $ 81.00 $
~tJc~"'I?ROffifRJ'.'(~OWNER?;"'Yi~:i!(-~~W?""h" 201 to 400 amps (2) $ 95.00 $
'... ""._..; ,:~ ,;.. ,,'" .... r ~O'.. _om .." .;~;~+lt\';~... ~J',..~__Jffl;;i.~
Name: n V Tii.h7f ~u.'.::>C~ c;. ~~t- 401 to 600 amps (2) $158.00 $
I ~O}('" /x6 '7 601 to 1,000 amps (2) $205.00 $
Address:
City: ~-we 1 State: OL ZIP 97l{f::J( Over 1,000 amps or volts (2) $469.00 $
Phone: - 1 Fax: Reconnect only (2) $ 63.00 $
- - -
E-mail: Temporary services or feeders: installation, alteration, relocation
This installation is being made on residential or farm property 200 amps or less (2) $ 63.00 $
owned by me or a member of my immediate family. This 201 to 400 amps (2) .
$ 87.00 $
property is not intended for sale, exchange, lease, or rent. OAR 401 to 600 amps (2) .
479.540(1) and 479.560(1), $126.00 $
Signature: Over 600 amps or 1,000 volts, see services or feeders section above
'*'~~'CO~GTOR"INSTA~I!'A ~
~~~::es;' ~:~e: tJ J ~ ;'.rl1' ','..,. r 0 Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Address: IJ 0 h,"y;, (II or7 Each branch circuit $ 6.00 $
,
ci;;v{;4 '1'U'';: -f 1 State:() tof ZIPCf7< '''if v, b. Fee .for branch circuits without purchase of a service or feeder fee:
Phone: /}.fF'7u1'-- rT\J 1 Fax: /jLfL/JOl. 7 First branch circuit (2) I $ 55,00 $~~
E-mail: h V;" v./ I J,-)l--O:>ji;l "11 ]t1 /), t' On 7,'np.( ~I YI Each additional branch circuit jLJ $ 6.00 $l5''i
CCB license no.]';; (Plit/to '-I BCD lic~se no.: .7/) tJv.'J.1 Miscellaneous fees: service or feeder not included
Signing supervisor's license no.~ ...,....., ~ "' I Each pump or irrigation circle (2) $ 63.00 $
-
Print name of signing supervisor: I~ Wt )~ Each sign or outline lighting (2) $ 63.00 $
Signature of signing supervisor/ ITJ Signal circuit or a limited-energy panel, $ 63.00 $
ore~, alteration, or extension (2)
ATTENTION: law requires you to Each additional inspection: (1) $58.00 $
rules adopted by the Oregon Utility _\~1.(~"'"~~-.-"'li"-Dt,jf~__ .~
follow c:s ..~,.c"",h. ,J"~Agel:leANTlItUSE~i~i~'- . j,. l'l1,:.:n<
Notification Center. Those rules are set forth (A) Enter subtotal of above fees
in OAR 952-001-0010 through OAR 952-001- (Minimum Permit Fee $58,00) $ Isr
0090. You may obtain copies of the rules by
calling the center. (Note: the tele~hone (B) Enter 12% surcharge (.12 x[A]) $/6 6~
number for the Oregon Utility NotlflcatlmlTICE: (C) Technology Fe"J5'{o.llf ~.\),\lnQI/ $ b 'Sf-
'Center is 1-800-332-2344). THIS PERM I' 0"1\ I ':.(In"'-nll:J!~.;,(A' $ /b?
5,:I'AHe~ ~,',l,d,~~'ri\:~, ,( ~ough C): I
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440-2584-1 (9IOB/COM)
AUTHORIZEu U,"ULI
COMMENCED ORQ ABfNDONED FOR
ANY 180 DAY PE'tifl- S PR ?,o /()
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~.OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00822
4660 MAl N ST 630
CITY Of SPRINGflELQ
225 Fifth 81
Springfield,OR 97477
541-726-3753
permilcenter@ci,springfield.or.us
RECEIPT NO: 2010000963 RECORD NO: 8] I-SPR20]0-00822 DATE: 12/06/2010
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Branch circuits with service or feeder each circuit 224-00000-426102 $84.00
Branch circuits without service or feeder - 1st circuit 224-00000-426102 $55.00
821-00000-215004 $16.68
100-00000-425605 $6.95
TOTAL DUE: $162.63
t&.::PAYIVIENfTYI"E",~"'.I":A.'(O.'.R::"(CAS8)\,R,DBQWLl':By'";,,C. O. M.'.IVIEN. T,S . 'C"_ AMOUNT PAID.. 1
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State of Oregon Surcharge (12% of aeplicable fees)
:!:e~~"'gy fee (5% ol.permit total),
Credit Card
00553d
BURRELL BROS
ENTERPRISES INC
$162.63
$162.63