HomeMy WebLinkAboutPermit Electrical 2011-2-8
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225 Fifth Stred. Springfield, OR 97477. PH(54 t )726.3753. FAX(S41 )726-3689
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DEPARTMENT USE ONLY
S1'iL"l..O(\-O 0 ZOO
Permit no.:
Date: Z - "i: - II
This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180
days of issuance or if work is snspended for 180 days.
NOTICE:
THIS PER
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
Commercial
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 479560(1).
Signature:
CONTRACTOR INSTALLATION
C.-:32 B
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 'I\'-,w.
in OAR 952-001-0010 through OAR 952-001- 0 ~'
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).
440-2584-J (9/08/COM)
FEE SCHEDULE
Number of inspections per item ( ) Qty. Cost Total
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 $ 63.00 $
dwelling service or feeder (2) Servit:es or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95.00 $
40 I 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 senrices 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 fceders 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 $%./ln
Each additional branch circuit , $ 6.00 $ W,IlD
Miscellaneous fees: service or feeder not 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 $
APPLICANT USE
(A) Enter suhtotal of.bove fees $ lOUD
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A]) $ :t.n
(C) Technology Fee (5% of[A])... ,. . $ "Ot:;
nT.p~~'r, f~es d ~~r' he): $=t-l.;r
..;:.... ,..
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-5PR2011-00200
4020 MAIN 5T
CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541.726.3753
permitcenter@cLspringfield.or.us
RECEIPT NO: 2011000253 RECORD NO: 811-SPR2011-00200 DATE: 0210812011
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Branch circuits with service or feeder each circuit 224-00000A26102 6.00
Branch circuits without service or feeder -1st circuit 224-00000A26102 55.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 7,32
Technology fee (5% of permit total) 100-00000-425605 3,05
TOTAL OUE: 71,37
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3732
. :'J
71.37
TOTAL 'PAID:
71.37