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HomeMy WebLinkAboutPermit Electrical 2011-2-14 ,. F,lectrical Permit Application - 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753' FAX(541)726-3689 SPRINGPIELD ~~. ;"'",,,'" YiIIJI '. ". DEP,ARTMENT USE ONLY 5Pflzo('~c 230 Permit no.: Date: Z-j'l-j! 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. . L()tAL'GOVERNMENT.6:P.P~O\fAl:>' ".,t;,. Zoning approval verified? 0 Yes 0 No ,,. .<.C,6,TEGORY.;dFCONSTRuctION'}r, D Residential D Government D Commercial ~~4Wi~JJ,()B;;;S.IT:I:"lINF".d~MAj;loNiiii.NI:lr;iGO,t'A'liION;~M~it5,:''f'i Job site address: /07'- ,. 6" sr, City: UJ State: OR. D3351 DESCRIPTION (fefLfltCE- 200 f'\ I PROPERTY :r11 C(u 107 Soy": Name: Address: City: Phone: E-mail: This installation is being made on residential or fann 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: 9(€~ ~~ Address: fO fYJX (;b3 City: fltAr;fI1$ /I1Q Phone:5'fI-~q/Z "2-05""0 State:e1C. ZIP:1745 Fax:S'fI-T'/b. O'?/9-. E-mail: CCB license no.: qS17~ Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor' BCD license no.~ 31'3 C 46C{4- S 5f(!I)eIV G6/ Ste~ ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth 'In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). ~ COMMENCE .~ ~ ANY 180 DA ~~ 440-2584-) (9/08/COM) \ v ~ \:l.... 'CY" \J"- NOTICE: THIS PERMIT AUTHORIZED !;~ ;;~;;':':ftf~~{~\t,)0-Frf~~~r};Rf::?~;F,EE'?~S_C.H E,P.liItjE:,j;:Wf;i;';,f~1)1(~;Wf~~~~~~~~:' "'- .~,;~" '. Cost Total Number<i.f,inspectiorisp~ritemO[ 'Qly, , . ' ,"'~;""'.".'" "-' - "_..,,.~,., .,' y ., p-" - ._-.~", '.... ," ~i' '\ea~';, : cost 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 $ $ dwelling service or feeder (2) 63.00 Services or feeders: installation, alteration, relocation 200 amps or less (2) I $ 81.00 $q\ 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 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) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder l10t 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: (1) $58.00 $ ;::i~~:~~;~at1~~~~t~(i:~~~~if~!~p,ebTc:ANTNu'SJ~1:j.~~:~i2':iC;~f,;;i~~;~:i~r.~:S~~:;};.I>:, '.': (A) Enter subtotal of above fees (Minimum Permit 1"0.'$58.00) $ ?/ , Sll~llln\eB2py, \iJ;:.~~ ~~J,.jt $ "7Z: ~G;.\LT.~f~.?5% uy $ &fOr- ~ e '1.'i1li su'i-charges (A through C): $ 9tt"!7 .Y r't:ntuu. ... , SP~:~.~. F.IEL~ l~~ ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.u$ 811-SPR2011.00230 1072 B ST permitcenter@ci.springfield.or.us RECEIPT NO: 2011000277 RECORD NO: 811-SPR2011-00230 DATE: 02/1412011 lDESCRIe.TION. _V"-:J;:,0;~;'Y, -\f~:,,;'iJf;2'-,';Al;f:'71:"-;\';-_'AC;e-d[jiilJ~c;6I5E L'" -, 'AMOUNf.DUE-~"-.;;;..':J -3ervice~.20~_~!'.s or less __----324-00000-426102 81.00 ~ale of.9reg~'2..~.':charge (12% of ~pplica?le fees) 821-00000-215004 ...!}.}2____.__ Tec~nology fee (5% of permil lotal) 100-00000-425605 4.05 .._~ TOTAL DUE: 94.77 Q::~:: ~~~COM'MENTS~~' ,"~~,:' ~" "~: (;*>,g~{t::~:, ~"A~OUN.Ti~A.JD'.;'--,;'F"~ ','2~~~~j 94.77 LPAYMENi:&RE".-~~ ;:'PAX.OR -'cASHlER::080wLS'By't- Check STEVEN'S ELECTRIC 3472 TOTAL PAID: 94.77