HomeMy WebLinkAboutPermit Electrical 2011-2-25
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DEPARTMENT USE ONLY
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Permit no.:
Electrical Permit Application SPR'NO"""
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225 ~;-;~hiSI~~.~~:i~;~;.~ld, OR 9~~77~~H~~-1)7~~~~;~~~~A~~~-I-~;;6-36~~y~- ~
71
Date: ;;;2.
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.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
Phone:
E.mail:
This installation is being made on residential or rarm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange. lease, or rent. OAR
479540( I) and 479 560( I).
Signature:
44().2584.j (9/08/COM)
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FEE SCHEDULE .
Number of inspections per item ( ) " Qty. C6st Total
ea. . cost
Residential, per unit, senrice included:
1,000 sq. ft. orless (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 $
401 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 $
20 I to 400 amps (2) $ 87.00 $
40 I to 600 amps (2) $126.00 $
Over 600 amps or 1,000 VOlls, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuils with purchase of a service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch circuils without purchase of a service or feeder fee:
First branch circuit (2) / $ 55.00 $
Each additional branch circuit / $ 6.00 $
Miscellaneous fees: service or fteder 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: (I) $58.00 $
'. , . . APPLICANT USE
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(A) Enter subtotal of above fees I . $0/
TQ\!iliijnum Per"!i,! ref~5J;C}.!l) IF THE W?~:
~(BrEilltMiz%'s'iJrch'a1i:.;-U2,x l'"'])?MIl I::' '"v' $ -;. '<
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'IRd):T?thriJI~ID1}!..;;;:(~~,~U1!))ONED run $ L-/ - /
t;fOT~t.;,ieM ~nld.~;r~barges (A through C): $ /<.
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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.SPR2010.00474
2782 BURLINGTON AVE
permilcenter@ci.springlield.or.us
RECEIPT NO: 2011000360 RECORD NO: 811-SPR2010-00474
lOESC RIP..tIOIii?,,!!.;:'::,:!i'..:ti":_:1~"'7 :T;')' "5(:::8: - ;; *:"~;-.i:::::~lACC6l.J Nj~CODE ""
Branch circuits without service or feeder -1st circuit 224.00000-426102
Branch circuits without service or feeder - each additional 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:
DATE: 02/25/2011
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55.00
6.00
7.32
4.75
73.07
6Ji~.Y"-~!;NT::'TIe~f~'" ~"~~Y9B.;:t:'c~sj:IIER'::;NNIACHADP\!h<-i:~$-_,~~gJ"~.M~.NTS~~;~Z?1':;:~> :~:;;<,; <>:~!';-t~ :.'8MO!J.N:r'~ AIDF.+~.': '~~~~2 " i~
Check' MIKE GANSEN CONSTRUCTION 73.07
8191 COMPANY
TOTAL PAID:
73.07