HomeMy WebLinkAboutPermit Electrical 2011-2-3
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Electrical Permit A
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
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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)
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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
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Zoning approval verified? DYes D No
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D Residential I D Government 1.l'itCommercial
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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
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Name: ~ u./s
Address: ,...:) O,J c c;- .
City: <oS jJ-r:-d
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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)
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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
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*,'" 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
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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)
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Credit Card wayne sylliaasen 101.79
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TOTAL PAID:
101.79