HomeMy WebLinkAboutPermit Electrical 2011-2-16
225 Fifth Street. Springfield, OR 97477.PH(541)726.3753+ FAX(541)726-3689
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DEPARTMENT USE ONLY
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Date: 2 - / b -/1
This permit is issned 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.
.;'t:100CAL':GOVERNMENT' M~ROVAU:"\"",,;f-f;~"it"
Zoning approval verified? DYes. D No
i:,},:;~iCATEGORY;:61; ::,c6NSTRUCTI()N!~i!J';",' ,.~,
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),
E-mail:
. CCB license no.:\ 'is'
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor.
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440-2584-) (9/08/COM)
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: N ~~. ~~f'. i.!~,!n-~_pe,,~;i~~~j ,p~'[.~!~~,.~::_~',)','~:~<:1 'q!_r. ' Cost 'Total
.i:'~~ao:: c.ost.
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 or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
40] 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 pane!
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 3 $ 6.00 $ /'€?~F-
Miscellaneous fees: service or feeder ':lot 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: (l) $58.00 $
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>l'h ,,'?iM\.'31,e:t.if0,Y;,:tK.i'>A'f,,;, .,",,-, _ m' _ ,:)! __ _ k/!,,,'J. "f~,.~:r~.~~:'o~,>1'~;'!,"v ~::::
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00) $ 7'!
(B) Enter 12% surcharge (, 12 x [A]) $ ;;"1r-
(C) Technology Fee (5% of [A]) $ 1'.1'
TOTAL fees and surcharges (A through C): $ RS'i -
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www.ci.springfietd.or.us
TRANSACTION RECEIPT
811-SPR2011-00246
3161 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenter@cLspringfield.or.us
RECEIPT NO: 2011000298 RECORD NO: 811-SPR2011-00246
[DESC:Ri e.'iiON - '. "., '.i':-;:l-~', ",~? ii, [.: .",' . ',:Y, lfr"iJ.f~;:.!;: ;'i.-;A:'C:~C:0U NJ=c:bDE"~;"':::"
Branch circuits with service or feeder each circuit 224-00000-426102
Branch circuits without service or feeder - 1 st circuit 224-00000-426102
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~te of ()."egon"::;ur0arge (:3.:" of ~plicable fees) ___~..1_::CJ1!.000-~15004
Technology fee (5% of permit total) _..2~0-01!.000-425605
TOTAL DUE:
~1t~5'MENJ=TYiiE:" -PA,(Q~_~f.;';SHlERDEii:iwtsBY'~':;;~:;'G.ONlf,jf~NI~? ;,-,':
Credit Card COMPLETE ELECTRICAL
INSTALLATIONS INC
DATE: 02/16/2011
,'-~ ~ ':AMOUNJei5UE< ';:r:.-;q
18.00
55.00
~-_._"-,-_._~--"-~-
8.76
---~-----_._....'-.-
3.65
85,41
"AMO(JNT.PAID~
-:J
85.41
073759
TOTAL PAID:
85.41