HomeMy WebLinkAboutPermit Electrical 2011-2-10
225 Firth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
'. ,-,', -.-,-
; DE'Pl\RTNiENTUSE ONLY
SP',:z 2-0 /f ~ 00;) /
Permit no.:
Date: :;:;;
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' ,,":il!()CAl:'GOVERI'iIMEI'iIT " ~PI'R.OVA8){,,*'jV(ni'.':~l
Zoning approval verified? DYes D No
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o esidential 0 Government
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o Commercial
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:PROPERTY,OWNER
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:
Business name:
Address:
City:
Phone: ~
E-mail:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
...----
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 t -800-332-2344).
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if~
f\F
440-2584-J (9/08/COM)
0~P~g~~~f~~~~~1~F:EE~SCREOUGE~~t~~~~~~~~~>>M
'J,'N ~~~e_~:~9!J?:~p,~ii~e:~~::,~~I;,~.t;:~:J;i::.~~r8i~,' ~~~~) Total
. 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 $ 63,00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps nr less (2) $ 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 $
Reconn~e~~ on~y _ (2) $ 63,00 $
i\iilIU.!"-"
Tempo!.~~r _se,!'vlces or feeders: installation, alteration, relocation
200 ampr'oi'Ie'SS:(ijVIII :'H!\LL CA,! KCI 1.0.0 ~':r
d ['T"IIr\,....'............. , n, .-..... ......11 .
201 .v r llVl "'.LU UI\tuLn 1111 ' r l..r '~$: l-h!~ VI
to 4qql!1mP.1"~)'r:n nn '0 ^ n ^' nm r. I!1'cAA $
to 600:,~~~~ii~ ~ ~ v, 'v "l.J/\I v ,. v
401 Df:Rlnn $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 ~ot 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 $
~[.~1!~~~t~~jf~ii'riF1f:A'RF?,i1IC:h[N:r:1~TJS"E~6,t~f,::~:slz~i;;~r~l(~1'[0f:H'::;;:,~
(A) Enter subtotal of above fees r;; So C "v
(Minimum Permit Fee $58.00) $
(8) Enter 12% surcharge (. 12 x [A]) $ \.~ ;
(C) Technology Fee (5% of [A]) $ z,.\
TOTAL rees and surcharges (A thrnngh C): $---; <,- (
.
S~.~'~N.G.._FIE~. ..
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~~EGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 8t
Springfield, OR 97477
541-726-3753
www.ci.springfield.or.us
811-5PR2011-00218
1307 QUINAL T 5T
perrnilcenler@ci. 5 pringfieJd. or. us
RECORD NO: 811-SPR2011-00218 DATE: 02/10/2011
"''''f:~ '" :"[, ,; "Jl;CC0lJNJ)::,ODE;.'AMOlJNT.DlJE,
224-00000-426102 63.00
821.00000.215004 7.56
100.00000-425605 3.15
---.---..
TOTAL DUE: 73.71
t<I'1AYMENT<TY. PE";' {~,;PAY()R\'~"CASHIER:NMA2HADO\': ;';S'o ':' '. C()MMENTS",,';t{ :'.<:;.G,.: j,~.,';,'i.AMOUNTPAJD";;)t.:~.,. ',tf j'
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Credit Card Steven T Adams 73.71
010300
RECEIPT NO: 2011000267
LDESCRIPTION:';'"',',;i "J,;;!',,:,'. ~
Security Alarm
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
TOTAL PAID:
73,71