HomeMy WebLinkAboutPermit Electrical 2011-1-7
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225 F:ifth Street. Springfield, OR 97477. PH(541)726-3753+ FAX(541)726-3689
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'DEPARTMENT USE ONLY'
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Permit no.: S!{)- ~
Date: 1- 7 -II
This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180 '
days ofissu.ance or if work is suspended for 180 days.
:':~.'(i!;l~t~;l'ii;6;t'-ObAL"\\GO.vERNMEN:r:;;APPR()VAt!;~:il:j,~f"(:' <:.
Zoning approval verified? 0 Yes 0 No
(\i;l!1~ii\!ti~;'::CATEGORY~!OF:!CONSTRLJCTION{:; ?'~,t'" ..
o Residential I 0 Government -[ ~Commercial
;'i".:1):~JOBfSITE',1NFORMATION'AND;J.:OCA TION,:. ,"i"
Job site address: 1I()~ Coml#1-e"'c./~ A-tle.
City:"'''....... ~,~tJ... I State: ()12. I ZIP: a71/'lfj
Subdr~ision: V V \ U./l..?::J, \ ~ I Lot no.: D
.j~:!:~g:~~~,~~!:~fSj~',~~~:;~~tDEscRI~;rIONFfOF~:"WORK.:1';,~:1~<,"f('~~:~b~'J;;~\;jF.':;-
A/F:vvEfeel.-tc...J. <V(fClrl k". (;l..,....v~
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; 1'~-- ;~-~~<~,(F::'::~il:jRROPERTN,:(O_WNER'~:r'~~::~~'~~~:;~'~~!:~:;,~.~'"t~:
Name: 15tA.4+ $1 d. C- 811 d ft ~+ e.-lt ....v-e-L.
Address: Ifol/c- r"'I14".ferl-'~ 1-ve..
City:, c.on_.J,"eI.l I State: n It I ZIP: tf7'-/79f
Phone:' _ " v I Fax:
'SCHEDULE
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Nunibe~r,of.irispections'per,item.t) . ,Qt)'.
;;"':',,.,:::~,,":;.:'~;(:~':""~'.,,:':,:-:.' ."$>'." :;, . ,;"" .. :,." '., . _ .''c"'L',,
,
Cns! Total
ea. cost
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
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)
Services or feeders: installation, alteration, relocqtion
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
601 to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
Ii $ 81.00
$ 95.00
$158.00
I $205.00
$469.00
$ 63.00
$jl!t ,.
$
$
$ 2JJS!<='
$
$
Temporary services or feeders: i,!stallation, alteration, relocation
E-mail:
Thi~ 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
479.540(1) and 479.560(1). . 401 to 600 amps (2) $126.00 $
SigtIature: Over 600 amps or 1.000 volts. see services or feeders section above
~~:~\t~~W;'~fl)~,,~rCONTRACTOR?INSTAl:;lJ'TIQN,"{"5;;.i,'~~~'("~~,:'~:;i',:~.;::;', Branch circuits: new, afteraiion, extension per panel
Business name: {\ n I 1\ /1 )() 1 J ~ J I /IT L,; . ;, j a. Fee for branch circuits with purchase ofa service or feeder fee:
Address: (JD v./l-U'f;/, ,.:2J~'o3 Each branch circuit 155 $ 6.00 $>'1'1
City~l I '"'"" A -",~/j j State:iJj3. I ZIP(}7lf 0 :L b. Fce for branch circuits without purchase ofa service or feeder fee:
Phone:~l/P -h'Rfo-'1-::1Jt::.1 Fax:c;U J Mh -;).715 First branch circuit (2) $ 55.00 $
E.mailJ I /)1;,,, 'tJ "n" J:. In. J' 1..-1-, ;" ./~ Each additional branch circuit $ 6.00 $
CCB license no.: 5H? X" 8 ! BCD license no~'-/ dSf'. Miscellaneous fees: service or feeder not included
Signing supervisor's license no.: '" l) dS d. S ..... Each pump or irrigation circle (2). $ 63.00 $
Print name of signing supervisoRi- JJ , ."'-.."'h '^ ~ /1 I/JJ J, Each sign or outline lighting (2) $ 63.00 $
Signature of signing supervisor: .J / ../'./ I . ~,ipa1. circuit or a Ii~nited-energy panel. $ 6300 $
../7" .,-""" - lp@ra~Qn, or extemaon (2) .
calling the center (N t . th e ru es by ~ <l:- ~ (e) Technology Fee (5% of [A]) $ 43 is
b .' 0 e. etelephone ~ ~ ~~
num er for the Oregon Utility Notification ~c:; ~ ~ s::; 'TOTAL fees and surcharges (A through C): $ /0'2." "
Center IS 1.800-332-2344). ~. ~ <:;::;s (}- {if li"J; z5Z'/O J;;(c.c.+m,..R.., P/CtI1 Ae.VI~ '1J Zl'1lJ
~ ?:/!j /$',;.,Q.
~ P Q.~,<, $ ~'<' f ofeL ~~""'ltf1~
~",~~~~$ (2.&1 trz.+5?~
<:s *' . '..YIlt.,
440-2584-1 (9/08/COM)
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'~'OREGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth Sl
Springfield,OR 97477
541-726.3753
www.ci.springfield.or.us
811-SPR2010-00409
4045 COMMERCIAL AVE
,
pe rm itcenter@ci.springfield..or,us
RECEIPT'NO: 2011000073 RECORD NO: 811-SPR2010-00409 DATE: 01/10/2011
!D'E'S'C RloTION''''c'--;',;, .'.. ..:.:,,: ;,' ..:' '''''",''': ".'c- ACC'O'U"NT'(jODE'i::" :," ,'" ". 'A'M OUN1"O'UE' ',.,"_.__" .<1,
ro- ,~~-,--"':""':'U-4~__---. .~'~"_~0~i_,~::t~.:'h,!;3L",~'~,e:-,-;._..!It_" .. ,;', J;'..~-:'--,,-'..-_,,~_'~_.. ,_ ~__> __,.J"
Branch circuits with service or feeder each circuit 224~00000-4261 02 348.00
._---
224-00000-426102 219,25
224-00000.426102 324.00
224.00000-426102 205.00
821-00000-215004 105.24
100-00000-425605 43,85
TOTAL DUE: 1,245,34
["PAYMENT,' :1"1(1'110,: "",,,,:pAVOR::iii ';~'CASH"ii(1)8ciwLSBY;':":;c6MMENTS'::~"~,;"i!:>,,;;f:~" ',' ;,';"AMOU.N,J.',PAI,.D, ;;-;, '. .":~
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Credit Card new way electric inc $1,245.34
Electrical Plan R~,:iew (25% .of electrical fee)
_~ervices 200 amps or less
Services 601 amps to 9~9 amps ._,__.
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
010184
~-----""'--'-
TOTAL PAID:
$1,245.34