HomeMy WebLinkAboutPermit Electrical 2010-11-24
Electrical Permit Application
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225 Fifth St....t.Springfield. OR 97477tPH(541)726-3753',~1r.'.(~V7a~;.3~82hhl.L FXPIRE IF THE
V';CRK f\UTHOP.l~ED UNDER THIS Date:
: ..,eL.;:-r IS ~'0T COMr.1"~'CED OR IS
This permit is issued uuder OAR 918-309-0000ip~~l'tiil~~f~'1l;,it~a~~'rir~';le~P"e'}.;:ft~1~Elre if work is not started within 180
days of issuance or if work is suspeuded for 180 days.
's'!"il!oCAI..:GOVERNMENr;4APPROYAI.:~\f~"~~.. "J
Zoning approval verified? 0 Yes 0 No
," '=€f~CArEGORY'.'OF"CONSrRUCJ"ION;L..
5
Name:
~
City:
Phone:
E.mail:
This installation is being made 0," 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(i).
Signing supervisor's license no.: ~d-S'75
Print name of signing supervisor: B~{i~i"-L.j- S2-e{r4
Signature of signing supervisor:
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.-. . .. tH:S ptRMITSHALL EXPhiE'!F THE WOR
WTHOr:;;ZED UNDER. THIS PERiViIT IS NO
CO~,~~';ENCED OR IS .l\6AI~DlJNEIJ FOR
440.2584.)(9108/COM;,'.IY ;SQ DAY PERIOD.
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"'" .SCHEOUI:E~$" "';"'-"":i,'';'" .':
r~.i~,. "'i0",';>':P;~-:,."","_ ,~-,"'<:~-~'-<:':-"'-, J:Y0'i^~r -::<-::::-::~ :- ,"'CoSt.. '~:', Total'
~N~mber_~fl?SP_~C:~2D~_~~r:0~~-!;t~~ g~: /.;+oLell>, j~~ 3__"';COS~';'"::
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) R $ 81.00 $ C/IR,' -
20 I 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 yolts (2) I $469.00 $ 1((:,(1.'
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 11641 $ 6.00 I $%y'
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder not 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: (I) $58.00 $
~~,~ .,' ..:"~:'rC;7JAj:iF'jjCANT~USE' ,._~:> "
(A) Enter subtotal of above fe-es (2,(0/,'
(Minimum Permit Fee $58.00) .
(B) EnterW2llb'Stifdb,arge1(li!;i?go[;:\'])W requires yo I to f$lIoiZ-5~.' ~
I~(C) Tecl[Jl?li?~FPfl!2~'6! (:gJ) ~..~~~ ~~~~tr. r-!{ ;i~c~t~ k-.'i.o5
I" TOT AE1fei;$ .n<! ~gr~~'rg...!((~-ctii;'o~gii.s;h'; u"~~~- r?,Ihl/ ..
CO I
pes 01 me rules oy calling the center (Note. the
telephone number for the Oregon Utility Notification
Center is 1-800-332-2344).
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00101
2800 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541.726.3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 2010000914
RECORD NO: 811-SPR2010-00101
DATE: 11/24/2010
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DESCRIPmIONij~ ,) j, 1, I' .",j U:;1;lNnij.!j)::F:;;i;):;/:;;;tj~:~';'.,,:, ~,';:~;;)iij:Ui!\l;qjjmHtlmWi'~'Cd-G~OJ~U:fr~G~QQ,E;;;:;;;.!rtf!L;;;::;>,;..~,:,.~t;:.'AM~QUNT'DtlE''';n';
.....
Services over 1,000 amps or volts 224-00000-426102 $469.00
Services 200 amps or less 224-00000-426102 $648.00
Branch circuits with service or feeder each circuit 224-00000-426102 $984.00
Permit Fee Adjustment - Tech Fee 100-00000-425605 $105.05
Permit Fee Adjustment - State Surcharge .821-00000-215004 $252.12
TOTAL DUE: $2,458.17
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. ,A",' ',;;:Hl'i!l1i:cAS'8IE.R:'l..fIOPP,ER ''';':;'~i~i'COMM~~I[$ijUU;!i;!:l/n';;;i;:;i~i:0" ;;,'''" "I,' .i~,w,. .;'. k, ;'.;-]
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I, PAyMENT TYPE
Credit Card
Bear Electric
$2,458.17
$2,458.17