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HomeMy WebLinkAboutPermit Electrical 2011-2-22 Electrical Permit Application 225 Fifth Street+Springfield, OR 97477. PH(541)726-3753. FAX(S41)726-3689 '. DEPARTMENT USE ONLY ....;,. Permit no. 5/1 ~ '2-7lf Date: 2.- z;z, - ZO If This permit is issued uuder OAR 918-309-0000. Permits are nontrausferable. Permits expire if work is uot started within 180 days of issuance or if work is suspended for 180 days. .......LOCJl.l:.c:;OVERNME~T . A~PR0VAL.:.'::.),.;" Zoning approval verified? 0 Yes 0 No ',iCATEGORY:OFCONSTRlICt!ONU' .' Name: 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: CoNTRActoR INSTAllATION Business name: ;,201::10,',,5 , ,,<- Address: ? <9. I City: / d....f jJ, '/1 7'J'S NOTICE:'" ''''''. THIS PERMIT SHALL EXPIRE IF THl=~ AUTHORIZED UNDER THIS PERMIT)S COMMENCED OR IS ABANDONED F ANY 180 DAY PERIOD. 440-2584-J (9/08/COM) ~~:_ji~::;i~~~F:~~~~:~'2(~ti;f~~r~TJ:iF;Ei;:~1SC_H-E_DXJtrE:g:J~'~":;::'i,?;/~~W&f:~1l~:~~%'itjt~ . " - '. ,," ".- Cost Total :Numberofinspe~tio'n!' perife,m ()...,; Qty. .. 'ea; .' cost ".:...,.;,.','.c... ',"_",',;"..,".-,'''-j-:-:' ",'. - '. 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 Jess (2) I $ 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 1,000 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 $ 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 pane! 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) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder not included Each pump Of 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: (1) $58,00 $ f~1~~gJf~~1~~~1.a~5~:6~~et~H~l(t;j:r32:U~:(Et:r'i:ri;:::.jCr:,i;k;;~n~;~~~<~i,K';l,' '" ',; (A) Enter subtotal of above fees $8\c? (Minimum Permit Fee $58,00) (8) Enter 12% surcharge (,12 x [A]) $Y. 1ft (C) Technology Fee (5% of [A]) ADS TOTAL fees and surcharges (A through C): $C\~ .:1- TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00274 7024 GLACIER DR permitcenter@ci.springfield.or.us RECEIPT NO: 2011000321 fDESCRlittI6N~,..,:,.~0 '.~?;?,Cf'" cr. Ji?Ji!::.f, Services 200 amps or less State of O:!9on Surcharge (12% of ~,pplicable fees) Technol99Y fee (5% at permit total) RECORD NO: 811-SPR2011-00274 DATE: 02/22/2011 'I.' V '\1':: ;.--' , 'ACCOUNLC6DE,,".,:::i:,",::J:5Y;;..:tAIIII6IJN'f:D(JC~"__-3 224-00000-426102 81.00 ------ 821-00000-215004 9.72 .___w'_"_ 100-00000-425605 4.05 TOTAL DUE: 94.77 ft7PAYM'ENJ~TYPE~"+:~,~~~,PAYOR;"vlcASHIER;:BRrCHARDSCrN~: '~i~'*.:1c'OM~ENTS':i'~'~':::-'>&{V~~Zb~0S~~f:rA~OLJNT, pAID r<", ' ~;n'~'":.~t:~" ::::J Credit Card ROBBINS ELECTRIC INC 94.77 093049 TOTAL PAID: 94.77