HomeMy WebLinkAboutPermit Electrical 2011-1-18
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225 Fifth Street. Springfield, OR 97477+ PH(541)726-3753' FAX(541)726-3689
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. Permit no.: srO-Oo ~Z ,
Date:
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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. '
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: instal/iftion, alteration, relocation
200 amps or less (2) $ 81.00 $
20] to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over i ,000 amps or volts (2) $469.00 $
-~.'Mt!o?~~~" '?-econnect only (2) $ 63.00 $
Address:
City:
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).
Signing supervisor's license no.;
Print name of signing supervisor:
Signature of signing supervisor:
. "" ",,' ::X<~V~):iA~~?;;~~,i;,'~<~", -,
NOTICE: IflHE WORK :'"V
THIS PERMIT SHf\LL ;.x~~~ERMIT \S NOTW
AUTHORIZED UNDERABANDONED FOR !'A'A'
COMMENCED OR IS .' Av..~rO
ANY 180 DAY PERIOD. . \~t9-Y
&
440-2584-J (9/08/COM)
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
40 I 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
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2) ,
Each additional branch circuit
$ 55.00 $ S...)
$ 6.00 $
Miscellaneous fees: service or feeder not i uded
Each pump or irrigatiopo~ir~Is((:zjte_s~ J\II\\. $ 63.00 $
EaCM8\'I9r6uili[1~).iiitiiig((2>~~""t~ 0\ 01 ~ 63.00 $
."-\'" -.rtU~.- ~Q\U\- I"')UJ
p.: Signal,,~i.rcu'it.or a,lirqited:ehergy<gan€l,'" 'ciI 63.00
Ie \lalter~ii?!!, Qriexiei\1i,q~\(2)0,\.l<J' . \ \\'Ie t~le $
~ )~~,~~tld'iti?!l~~(~isjJeCtfcl~\p)l\le ~~ _ i .Iea On$58.00 $
II '~J!>ii;'" . ",W..,"b ~-;;;"'"'' '. "~,lI>".&'1"_;;mg..">mll!.
~>:.f;~~'< ',: ' ,,~~I~. r:.J.!U.~~f'liH:.l. ~,.t;jlmpt~!~~~1~.Ji~~
(~)ll'Eri~~;~t.b'lJj~f'ab~~~t.-
nPi::.n ,- (':) \5 \ l;;l : $
(IMii\lmn'l1El/t!.%it Fee $58.00)
(B) Enter ]2% surcharge (. f2 x [A)) $
(C) Technology Fee (5% of.[A)) $
TOTAL fees and snrcharges (A through C): $
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, ^, OREGON
TRANSACTION RECEIPT
CIlY OF SPRINGFIELD
225 Fifth 5t
Springfield,OR 97477
541~726-3753
www.ci.springfield.or.us
811-SPR2010-00829
497 68TH PL
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011000110
RECORD NO: 811-SPR2010-00829
DATE: 01/18/2011
224-00000-426102 6.00
224-00000-426102 55.00
821-00000-215004 7.32
100-00000-425605 3.05
TOTAL DUE: 71.37
!8imp'A'y'M'" 'E-N'",i.""'DEll'i!!Ji!!J11"~A>Y.'O--"R'-~"mmC;SHiERi-ilBlWJi.!SBym18ii!!J8if"C-....O-MM-----EN...T1..S.mtiti"11i!;i:"W'>1&"1iii[Lllilj1[L1i!!J1f"I0[Lj.1A. .1M.....O.....U.....N....T.1;
...A...'''i!!Ji!!J.]i_1;;;.1J-.1j1;111[L!!!-'10;1'
h.~. .'""'-' , ..,I1i1iltJ/f2 . "zzz"",r:. .....; "", ..jz."." .. .. ,...... ~_",",,=.,j1.V""'. ~ ..;u='wh""".w"O",..j"'......1..,~.;V.L..oo. '".1"7. ,",i@0n.z;>~''"''2J''''o.ImK>!
Credit Card pk contracting $71.37
Branch circuits with service or feeder each circuit
Branch circuits without service or feeder - 1 st circuit
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
008429
TOTAL PAID:
$71.37
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