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HomeMy WebLinkAboutPermit Electrical 2011-2-25 -' / "'Electrical Permit A 225 Fifth Streett Springfield, OR 97477tPH(541)726-3753tFAX(541)726-3689 ii:ji DEPARTtilENT, USE ONLY' Date: This permit is issued under OAR 918-309-0000. Permits are nontransrerable. Permits expire irwork is not started within 180 days of issuance or irwork is suspended for 180 days. . ,LOCAL. GOVERNMENT.:MPROVAl. Zoning approval verified? 0 Yes D No .. CATEGORY,OF.' CONSTRUCTION: '.' o Residential 0 Government Commercial 'JOB SITE'INFORMATION AND:tOCATION: Job site address: J I P C? 1-<. kt r G~ ~h 7 R~ference: Taxlot. \ '". ;.> :f':',.'.~>'~DESCRIPTION,OFcWORK;;J<'."""':~;':;:'" ".'>. ;/{ I (,.-. ~ " , :;pROpERTY' OWNER'~ C"o..- VI I- 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, excbange. lease, or rent. OAR 479.540(1) and 479.560(1), Signature: . ,'~."(';:';~1,~';iCONTRACTOR~INS:rAIlliATIONr.;i~;':ic~'::;",i;;,';:;J Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~~.~~ ~. 440.2584-1 (9/08/COM) . :::,:,.>,. '. :',;: ;FEE,SCHEDULE.';' .~. ;. ' .. ." ... -'. :.. <0_"'" ~.. ,- .-', ""':.r" ,,:- ,...., 'Cost " Totil , N~~I:,~r~~~~~:s.~r(~~~~(:~, Qty, . ':'08::. cost. Residential, per unit, service iocluded: 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/-.C?-) ,....1... ..L8.M,~~ .L. rcr.1Tlrnd. f"I...""..... .~ 20J to'4oo ~fl.)JW ruies adODl--;' j bv Il$J'9~.p~~ ;1$ iiti!itv 401 to 600 am~(ii)ication Center, -has ) $l5a:oor ) set forti I 60] to 1,000 ~~(~r t;!v.::,-uu [-UU [II UlIl u."" '......r t"?'::4UU I ,D.. v""" ..........", ,.,1.,+..., n "''''' ,1~0~P9h , ~..I~,... 1-... . Over 1,000 amp'<miY.?!l'! (f)e ~~nter, . . -.- - - (No e $~~to!!J1 )~lOne Reconnect only'(lijmber for the. Ore ~on J $li63.00~ ifs:ation Temporary services or ieea~lis~li,r,ttaiia'i;biCgtle7-;/iig:t.i-~location 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 Il~I'~~~L- BraDch:cin:uits: n~ alteration, extension per panel . a. Fee~forbranchl cirCuiiS'Wiih purcliaSe'-oC;a _st~c.e~o~'~~~ fee; Each t:rim~6,b}~u'iF' J;...~ 11110 r T\IV:II, ..J I'" I $ . $ 6.00 -- -- - .-.- ~ - .- . _ . .....,. .,......... ....,,..., b. Fee 'for biBiich ~lrC~ii~ w~t1iOut'piirchi:tse'ofa serviCe or feeder fee: First branch circuit (2) $ 55.00 $ Each additional branch circuit $ 6.00 $ MisceUaDeous fees: service or feeder 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, I $ 63.00 $b?,()( ) alteration, or extension (2) Each additional iospection: (I) $58,00 $ ~~~'i;$!:,""~~a:fNt. 'W' '''''f~''~!<t;'.i; _,...,..~~it. ':~ :~,,>li1! ~ -: . CA ci',USE~~",fT*,jY';\;!,f,-.'~.}~'~:,1~j~ (A) Enter subtotal of above fees $ (1 On (Minimum Permit Fee 558.00) (B) Enter 12% surcharge (.12 x [A]) $7.St. (C) Techoology Fee (5% of[AD - . $2. IS TOTAL rees and surcharges (A through C): q~.7' (.. TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 81 Springfield,OR 97477 541~726"3753 www.ci.springfield.or.us 811-SPR2011-00307 3100 PIERCE PKWY pennitcenter@cLspringfield.or.us RECEIPT NO: 2011000353 RECORD NO: 811-SPR2011-00307 DATE: 02/25/2011 !DESCRIP.TIOril '>'{,.CC,,-'?f!IfJ:,". "~": '''~-,'''";f:rr:':~c~;,:,P.i':}]ACCOUNt:cbDE)'T~+?:L'.7;:;;:;. '.' AM()'U Nftou EL--:......:...iJ Signal circuit(s) or limited~energy panel, alteration, or extension 224-00000-426102 63.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 7.56 Technology fee (5% of permit total) 100-00000-425605 3.15 TOTAL OUE: 73.71 ~'"'PAYME";f)rNP-E",~~\~~RA~Qf{r~'CAS.HIER:':'~M:A'CH;ADo~~;:')k;?,.';'^,,~c6MMEN'-tSi.'::~.L~.~; .~;~:~~a~MOUNT PAID -;";";:":""f ' '.~J Check SECURECOM INC 73.71 48019 TOTAL PAID: 73.71