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HomeMy WebLinkAboutPermit Electrical 2011-2-3 ... Electrical Permit A 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689 ~!~ip;~r~~~&]~ii~m!. SIll L 0((-00 ( 7') Penn1l no.: Date: Z - 3 - I / 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. Signature: Over 600 amps or 1,000 volts, see services or feeders section above ~:Q:<DNm~'Cj]QB11_t;r~ro~~gJXilllQ:&It~al.~.i~\1f:~ Branch circuits: new, alteration, extension per panel Business name: F/~<:)-t' I..L'?:;j-r:: ~/,;, .-,<' A'C ')-J. ~ a. Fee for branch circuils wilh purchase ofa service or feeder fee: Address: r-;7fV9 7)/< -,zS.;1- ,( l?Vr1 Each branch circuit I $ 6.00 $ b City"-..S>t'/;b,..- ::J" /' / I State:o~ I ZIP: 9"7V /.jlf b. Fee for branch circuits wilhout purchase ofa service or feeder fee: PhondYl-&<:::- 7"p(3YI F~~f )26-02961 First branch circuit (2) $ 55.00 $ E-mail:<5o/"',.0'~ ~-4~),:/y(3 ~.L-'o <:::""'~ Each additiomil branch circuit. $ 6.00 $ CCB licen~e no.: /"./ 5f"o//h I BCD license no,: c~"t.. .<L I Miscellaneous fees: service or feeder not included Signing supervisor's license no.: ~/", '7'0 -S Each pump or irrigation circle (2) $ 63.00 Print name of signing supervisor: ':;/A9".P'e h1 . -.$'4-7'/' Each-sign or outline lighting (2) $ 63.00 Signature of signing supervisor: DI".{. /~, '/" ~ 'signal circuit ar a limited-energy panel, $ 63.00 $ alteration, or extension (2) f~J~;~~I~sN~~~;t~~n ~:~~~~~~~~iI\~ Each addition.:~:~sP;;~~~~kN[~U,~. Nolification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- (A). ~nter subtotal.ofabaVefees 0090. You may obtain copies of the rules by '~, I;! :J(Mm,mum Permit Fee $58.00) . calling the center. (Nole:. the telephone ~I\ 1),:15 F E(!'!\?TJ!er;ffKt~q:\l~.,t\tIl'fi<T<MiE WORK number for the. Oregon Utility Notification \J\~ WUTHC [(8)' m""l"""'" "''''!!'''' """'''''I'lIT 15 NOT' Center IS 1-800-332-2344) \\'0" .t!" '!!1p.QarrremV' "'Uf\ J . ~'~ JOMM :T.ofJ\lr.OOejS1D^&SiI~cllml.!iQklf,R,ughC): ~ ~.~~Y 18u UAY J-'l:KIUU. . ~ ~i:'~~t.!:G?JW&l!1ilG:QME~NMIO'N[IP,:~P.8.q\lA~' Zoning approval verified? DYes D No ~;f'iAi(::;>>:i1iEG:ORY~O,fLG:oN$i]~l!J:QmIQN~1f~~ D Residential I D Government 1.l'itCommercial ~~,QB)jfS'f;tE\1fl)lF.QJ31Y1~ID1QN~A'NP'ltl!oP'h.iIjlOr:IJ!!~~! Job site address: /0 7 ';"'S'l.J"-;"1rG ~ City: <....5jbJrJ ~ I State: ~ I ZIP: ~?f/7/ Subdivision: I/O '3. ~ t( ( ( I Lot no.: 0 ')60 C Rl_""""""ss_,,{:- ',"'" "', ..,,'" ",",'", "'''''''~i'!il~'''''ilifS' ~____:!';,<jp~[)I=.S,!::R!gm!.G?I)I-",@,J;iilWQRK?1i7i~lm:',,,,~,,,,,,~:'i!l~ ,..:)ee? ? F~-/Y.c, - ' ~ / L d c:::;- ~ C-L.." G ~{~it~~a;8.gF!ERill.Y..iQ,W:NgR~J~.!I!iilir~~f,;Wl~B Name: ~ u./s Address: ,...:) O,J c c;- . City: <oS jJ-r:-d /XV/. I State: e>.e I ZIP: "T7V/ I Fax: - - Phone: E-mail: Tbis installation is being made on residential or fann property oWDed 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). 440-2584-J (9/08/COM) i;.gj$:C::8'gst:nr' j~'r'> ;j; :urn ,~~ 'im:".!'&<,'''''''' ;",,-. 1>!,~-"".'o~,,- _,' " ~_ ~~:t. Residential, per unit, service included: 1,000 sq. ft. ar 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) -"l.ervices or feeders: installation, alteration, relocation 200 amps or less (2) J $ 81.00 $A) 20 I to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 60 I to 1,000 amps (2) $205.00 $ Over 1.000 amps ar valts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps ar less (2) 20 I ta 400 amps (2) 40 I ta 600 amps (2) $ 63.00 $ $ 87.00 $ $126.00 $ $ $ $;;;7 $ 10 Lle( $ /.fJ.j $/f11 7.1 , WI' SP.RI~.:'':''.IE.L~.... . ~.L._. . q;i. "".... ',," ...~ *,'" OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00175 937 SUMMIT BLVD permilcenter@ci.springfield,or-us RECEIPT NO: 2011000224 RECORD NO: 811-SPR2011-00175 DATE: 02/03/2011 rDE-SCRIRfibN'i;:',~,~::tij;~ff_j.~~ ,/~;!,+'''i;f5'rt ~.." 1-,i'y~,'4!:;~~~,~E~~i_:2Ae_c,bJjN'jr:C0DE'" ;j;;\(1i1.~; : ,",' ~~~~::::"A'M6dN~tbuE..-i_~L~:::~J' Branch circuits with service or feeder each circuit 224.00000-426102 6.00 -_.,,-,--~ 224-00000-426102 81.00 821-00000-215004 10.44 100-00000-425605 4.35 --~-~ TOTAL DUE: 101.79 Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fe~ (5'% of permit total) B:R,~XM~t!T:fr,P'j~;;j;?':1 :E,~iQ~~{~.fls.ill\R:-6B6wi:sBY-_.d~4it8ttG~QM~_(~.fs1:J~;;~,/~frtr+f('~~2dl:f:~~i4A!\IIOUNT~p;ArD~'~~;"':_~Jji~:!1~;{] Credit Card wayne sylliaasen 101.79 r6933z TOTAL PAID: 101.79