HomeMy WebLinkAboutPermit Electrical 2010-12-15
Electrical Permit Application
~ Pennitno.: Sf,tOZ6/0.oC 'to I{
225 Fiftb SCree + Springfield, OR 97477. PH(541)726-3753+ FAX(541)726_368~
tl Date: IZ-/5-10
This p rmit i~S~~ ~nder ~:'~30~~,';.er~::0 ansferahle. Permits expire if work is not started within 180
days of ance or if work is suspended for 180 days.
(A) Enter sUb,total of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [AD
NOTICE: (C) Technology F~~(5%'OfrA"j)'
THIS PERMIT ( ff~X~lrnid!;ulilli~hrough C):
AUTHORIZED UNDER THIS PERMII It> l~uT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
'.
'.'\i!j",ii:'p.,iEocAl1::'.GOVERNMEN:n.AI?I"ROVAL."j"t"j;} L
Zoning approval verified? 0 Yes 0 No
'L'.tij;'";1ltj::*:CATEGOR't:OF.:coNSTRLJCTION",~.j'.jj::h'::i,:'I!
o Residential I 0 Government I ~Commercial
;,\',01'!JosilSI'l"E"jINFORMATION;'ANo"lZotATION',lli1h:,;:l,
Job site address::p,o~v ~L..::>.I t .j:\e,,~""~v~1:. Wil.,
City:s.,. '" n"'f;'c. \c:l . I State:OR. I ZIP: ~.
SUhdiViSi~cJ.'N\lSt. I Lot no.: ~
\ ."... . I \ <Y>4. (" .~ :~" .s.. or \ ^
~"'.LO 11''''' ..:t'.....I~
Name: e~;t\\ R $:cv'-Ylo. nc\.d..
Address: '~'2.'S: r:;,tl.1 -s..'t-.
City:Sc>-1.I'\C1.~c-\.d I StateOe. I ZIP:
Phone:~"'l..l... Fax:
E-mail:
This installation is being made on residential or farm property
owned hy me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(I;;.ndi,.~1). M' /l ()
Signature: "'-
'~"?'j%;~;;l,i;CONTRAC'l"OR;INSTAL:IZATION f,~'i;,;;:iirJ,jii .. ",
Business name: EC Company
Address: PO Box 925
City: Alpany
Phone: 54;1, - 92 6 -42 6 6
I State: OR I ZIP:. 9,7.3 21
Fax:54;1,-926-4268
E-mail:davidom@e-c-co.com
CCB licenseno.:49737 I BCD license no.: 22-15C
Signing supervisor's license no.: 3257 S
Print name of signing supervisor: wi 11 i am Coburp
Signature of signing supervisor~,((, 1; h Q
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Nolification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. 'tau may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Ulility Notification
Center is 1-800-332-2344).
440-2584-J (9/08/COM)
lo5Dlo.3
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-., ';*IQty~~;; ";,~~:;.L
"\\2[~~~ti~ ,.u_c()st-,
Residential, per unit, service included: .
1,000 sq. ft. or less (4)
Each additional 500 sq. ft. or portion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Services or feeders: installation, alteration, relocation
200 amps 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 $
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)
201 to 400 amps (2)
401 to 600 amps (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
3. 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)
Each additional branch circuit
\
$ 55,00 t,~Dl
$ 6.00 $
Miscellaneous fees: service or feeder not included
Each pwnp or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alt~ation, or extension (2)
$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
Each additional inspection: (1)
JsE
$58.c&
$ ~."I(g
$ 2."10
$(;, 7. 8&
.-
www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00904
2401 PIONEER PARKWAY
EAST ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenler@ci.springfield.or.us
RECEII'T NO: 2010001056
RECORD NO: 811-SPR2010-00904
DATE: 12/15/2010
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lDESCRII'>;rION:,':,'-,-#c.;t-r::. 'c~' c"f' ":;"';:~"'~~(:-:.':-" ; '~C_C9J.1t:l:r;;,C.oJ)E':';;,;;;;;':;r:AMOUNT DUE r
Branch circuits without service or feeder ~ 1st circuit 224-00000-426102 $55.00
Balance of Minimum Electrical Permit Fees 224-00000-426102 $3.00
State of Oregon Surcharge (12% of apylicable fees) 821-00000-215004 $6.96
Technology fee (5% of permit total) 100-00000-425605 $2.90
TOTAL DUE: $67,86
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~. j
Check
4242
ec company albany
$67,86
$67,86