HomeMy WebLinkAboutPermit Electrical 2010-12-20
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Electrical Permit Application
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753HAX(541)726-3689
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DEPARTMENT USE ONt. y .
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Permit no.:
Date: /2 -lO -(0
SPRINGFIELD
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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Zoning approval verified? 0 Yes 0 No
('i;'!::'{r::i\dCATEGORY;':OF;'(CONSl'RUC'l'ION~"r,,-
D Residential D Government IEJ:::.Commercial
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Job site address: S'C 1" I
City:
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Name:
Address:
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ZIP: 7')4<.)(
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).
Signature:
CONTRACTOR' INSTALLATION'
c.. N.
City:
Phone: \
E-mail:
CCB license no.: ~}/..Q
cz.. ZIP: q'li.1
511/ 6,tq /2-47
Signature of signing supervisor:
. regon I re I l
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies 6f the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
440-2584-) (9/08/COM)
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,Number o!inspeCtion'Rer iteiniO, ,'. Qty;
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Residential, per unit, service included:
1,000 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
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] ,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 $
20 I 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 ofa service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder ':lot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, I $ 63.00 $ &'~( J
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
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(A) Enter subtotal of above fees b3:
(Minimum Permit Fee $58.00) $
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(B) Enter 12o/~surcharge (.12 x [A] 7
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(C) rechnology_ee 5 ", 1\ ~..,('-;;~iHnIT ,::; NCl'f 3 '->
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TOT~~ f~~~Wil r r ~sl((~.rA~~~!H R $ 7<. --, I
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ANY 180 DAY PERIOD.
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00938
4660 MAl N ST 620
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenler@cLspringfield.or.us
RECEIPT NO: 2010001100
RECORD NO: 81 I-SPR2010-00938
DATE: 12/20/2010
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Signal circuit(s) or limited-enerQtpanel, alteration, or extension
Technology fee (5% of permil total)
State of Oregon Surcharge (12% of applicable fees)
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224-00000-426102 $63.00
1 00-00000-425605 $3.15
821-00000-215004 $7.56
TOTAL DUE: $73.71
"C:QMM~Nt$j\':''::'~j;'';7~!~-j-~2:~;i:AM9JJNT PAID' / OJ. ,', .1
I "PAYMENT tYPE-'- ,c"iPAYOR' -'0'CASHIER"bB6Wt.SBY;;~
Credit Card
985498
ttc communications inc
$73.71
$73.71