Loading...
HomeMy WebLinkAboutPermit Electrical 2011-3-1 .' /Electrical Permit Application CITY OF SPRINGFIELD, OREGON 225 Fifth Streett Springfield, OR 97477.PH(541)726-3753.FAX(541)126~3689 ~nDji DEPARTMENT USE ONLY I 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. NonCE THIS PEP 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 o Residential 0 Government Commercial JOB SITE INFORMATION AND lOCATION "-C Ie Name: Address: City:ec Phone: E-mail: This installation is being made on residential or fann property owned by me or a member afmy immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560( I). Signature: CONTRACTOR INSTALLATION E-ma". Business nameS' Address: .'- Cny: r Phone. CCB license no.: ~ 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 952-001-001 0 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 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. It. 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 $ d\yelling seryice or f~~d_~J (2t -. - Services or feeders: instal/ation, alteration. relocation 200 amps or Jess (2) $ 81.00 $ 201 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 or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63,00 $ 20 I 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 panel a. Fce 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 $ E~ch additicnal branch circuit $ 6.00 $ Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) ~O- 'li Each sign or outline lighting (2) /) $ 63.00 ~/'3 Signal circuit or a limited-energy panel, \ ../" $ alteration, or extension (2) -,-...00 Each additional inspection: (I) $58.00 $ APPLICANT USE (A) Enter subtotal of above fees b3 (Minimum Permit Fee $58.00) $ (B) Enter 12% surcharge (.12 x r A]) $ 7::'0 "" (C)Technology Fee (5% of [A])" $ 'JIS '" ~nlTrAIAees and:s1lrt:hjfr~}1€:\ \fIitdiig~ C): $ <"J ., 1 ~IlJ-o.I' 'I II 1L.. . .. .' -. '\ /~$ 73 ,/ , '" // '-.------' .- " SP~INGFIEL~ 8i~-~ Ek.~ = . OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.cLspringfield.or.us 811-SPR2011-00291 1922 Marcola RD permitce nter@ci.springfield.or.us RECEIPT NO: 2011000369 RECORD NO: 811-SPR2011-00291 IOESCR!PJ'ION:;S" .,' ~'.F.~"; "",,0; ;w:L~~i;,; ~..;\l"0?r;:;l:Z;_':..",l\CC6uN:rcC.OtlE:~.L" __:-;i9n or outline 1i9hting 224-00000-426102 . State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 Technology fee (5% of permit total) 100-00000-425605 TOTAL DUE: ..PAydRr,~'CASHIER:nBbWLSBY~./ ,:".;~fz:~: G9MME'~i~~t~; '\;. Signcraft electrical advertising lie DATE: 03/01/2011 , ''''l\'f1\N10UNI.i:>UE_.''::~:.J 63.00 7.56 3.15 73.71 , AMOUli'!/PAIQ ,1 73.71 ~AYIlliENif-fYPE: Check 1453 .- ,.." .....,"~ 'c.., ,;.-r"--"'Jz;';,' .. TOTAL PAID: 73.71