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HomeMy WebLinkAboutPermit Electrical 2011-1-21 225 Fifth Street+Springfield, OR 97477.PH(541)726~3753.FAX(S41)726-3689 ":,1 . DEPARTMENT USE ONt. Y .. SIlt. ZOC(- 00 10 0 Permit no,: Date: 1- 2/-1( 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. "," "'LOOCAVGOVERNMENnAI1f'ROvAI:1!~i"i"i~";i"'!~'~' Zoning approval verified? 0 Yes 0 No ;CATEGORyjiO";:CONSTRuctfoN\';'X' '. , D Residential D Government Commercial ~~~!;lJ:OI3;)SIT:E\~INFORIVfAT:ION0\~ND~COC-A'T:ION\i!i"!l~~;' 5:10 me;..- F,~ I State: oIL ZIP:" '7t{73 7c) "s I..( Taxlot. 0 "J 10 I . .DESCRIPTION OF'WORK";"';'J~'\:'" e. !--en f ~ .... S- c { f<:..J L, ~ 4- ( ::-. c:... 'PROPERTY OWNER dS Name: m.e S::-7o ,'- '::> ~A ~r(-'", 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). Signature: Address: City: C<. Phone: ' E-mail: IL 0... () I , Co r<\ BCD license no.: 2-V- 38 Y'Vo7.f V'~ 0; ~rc. Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: (~?F';:;:~fi:;(~f~~~~I.~{~~.:L~'1.I;EE-~SCH ED.8I3EfAJtM(i1;i~~~:~~"1~~~,~ft~~ .' ........ '.,'. '" -,., Cost . Total i,NulI!~er'qJ;in.spe~tio~~p~r)t~m'O. ~;r. 'Q~'y. ,...,.", <:,' ,., ."....'"..",'". . "I ""'.k. ..\~,.:", .',.' ,",> ;,';'ea~r;, c9st '< 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 ] .000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: instalLafion, alteration, relocation 200 amps or less (2) $ 63.00 $ 20] to 400 amps (2) $ 87.00 $ 40] 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 of a service or feeder fee: First branch circuit (2) I $ 55.00 $:>S Each additional branch circuit It $ 6.00 $ zA" Miscellaneous fees: service or feeder 'Yo! included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 53,00 $ Signal circuit or a limited-energy panel, $ 63,00 $ alteration, or extension (2) Each additional inspection: (1) $58.00 $ :W~.lF",jiiil!"1!,~iitl#i!'~ARRt.ICANt,,!'tISE',J,;'S(;H;~,;i';"';"<''i .1"'...." :ili\'ij.~." __<:s;.\,,~.t.J>,.0"I~~f;~;, .':..(:': ..' _.: ;,;; . '. ~~~J"..,1ii-,';b~i'-i:ic:~!;..,;>,~]:~~t':'?'_' (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ 71, 06 ~11jIill:~nter 12% surcharge (, 12 ~'[;\]j"""'i' - q .lj~ .. $ c 'PPR~R'I'V~t~;:J=ljI1iJ\f~~~~ . $ 3.C't.5 '''OO1MlfUW~~):'' $C)d.Y3 o OR I::; r'_ ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-001 0 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notiiication Center is 1-800-332-2344). tfi ~ NO . \Jv THI AUT COMMENCE ANY 180 DAY PERIOD. 440-2584-J (9/08/COM) - ,_ 'AI TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00100 5701 MAIN ST permitcenler@cLspringfield.or.us RECEIPT NO: 2011000140 RECORD NO: 811-SPR2011-00100 DATE: 01/21/2011 lDESGRIF'TION"':':,:,:,;,~..,,,:. ~:::'S~17" .'; ":';c::J,:C.1Z::"c '::,:!~L:<\CC0LJNtCODEl;":"",!:~"-:Js;6,,,:.o:MOUNT.D(jE::': > ' '. :~ Branch circuits with service or feeder each circuit 224-00000-426102 24.00 . .~.~._. ______ _ .___,__ _~__.___,__.. _'.'W'_ ..,_._.._~ __,~_._.. .. ..~.. __.~~___.____ _ _______ _. _ _ _____ _ _ .__ Branch circuits without service or feeder -1st circuit 224~00000-426102 55.00 __..__'._____u..___________ .~_..'"___.____,____~~.___._.. __ _ _.__._ ___ _______.. _ . State of Oregon SurEharge (:12% of applic~~I:.fees) ___ 821:E9.~00:..~12.?_04___.__ 'n'_" ~~8_.._ _ _ TeChnology fee (5% of permit total) 100-00000-425605 3.95 TOTAL DUE: 92.43 li::~~r.Mg.NTdyPE'-"':'1PAYOR0;j;:~:,ill.t<'EtR:1'iBi5wts8(- '.5i,;'C9iiifM.~NIS.\l:ia;;;'t;r,". i""i~:,.;,~AMc:tLJ.!'lTj'AID..: .: ;:", 1..: 1 Check pioneer electrical contrcting inc $92.43 3157 TOTAL PAID: $92.43