HomeMy WebLinkAboutPermit Electrical 2011-2-24
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Electrical Permit A
225 Fifth Street+Spriogfield, OR 97477tPH(541)726-3753.+ FAX(S41)726-J689
SPRINGFIELD ,,' ;!','.
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$1"12. ~610. 00 C? 8 g
Perrmt no.:
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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.
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Zoning approval verified? DYes D No
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Residential 0 Goverrunent 0 Commercial
/,;':tn{'UQBc.iSIT!;:;'INFORMATION 'AND,iCOCATION"'PP:"F"
Job site address: Z' 0 LA 1..1. itA- :5 I
City: :s flllV\~ .~/c!. ZIP: 747?
Reference: 170 271 ( Taxiot.: OZ\ 0 C
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Name: }:)o I.. c>n..e-~
'Address: b 7:!O
City: S p'r.. 71(77
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).
Signature:
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Business name:
Address:
City: L
Phones
E-mail:
Signing supervisor's license no.:
Print name of signing supervisor: .
Signature of signing supervisor:
\fOTICE: .. RE 1FT HE WORK
,HIS PERMIT SH!\LL E.,PI MIT IS NOT . 5
'!\THOHIZED UNDER THIS P~HH:'O~N (e~;~\~~c
~ '~JI\iIENCED O~?J~~~.~' ~r"I~ 1 \:'1 If 7~\es f\1I
~ \ "NY 180 DAY P~!i;(y.;\,~~s~.,\r(,:";~~~\.c;\" O~~
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':.J . .' \(\000 '10\l r~a.~en\er. \\'lu'~'~'\'\\'J \,
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~bel \0' 's ~ ,SO
. (\\l'" Ge(\\er \
440-258H (91D8/COM)
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Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ $
thereof 25.00
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services f([~d;r~ta/lation, alteration, relocation
200 amps or less (2) / $ 81.00 $ 'll
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 $
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: ne~ a/terCftion, extension per panel
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 $ 6.00 $
Miscellaneous 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, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
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; "(..SiErltor subtotal of above fees I
~(^iininitim Perm it Fee $58.00) $ ~
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((Bt~~\\'! 12% surcharge (.12 x [A]) $
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. JY.H_,~hn"ology Fee (5% o[[AD $
410T AL fees and surcharges (A through C): $ 9t1?1
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2010-00988
2150 LAURA ST 31
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011000344 RECORD NO: 811-SPR2010-00988 DATE: 02/24/2011
!DESCRIP..TION:;;;';~::;:-';::";- 'if!__r::'l'I'f,:;:-~"",::'1>"3~":::,-_- 'p,' ,,: ~;6.c:e_6XJNTle_6DE: il-~'::-:l:jii;;-:J-: AMOlJNT:DUE:-1;-';"':
Services 200 amps or less - 224-00000-426102 81_00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 9_72
Technology fee (5% of permit total) ~..200-00000-425605 4_05
TOTAL DUE: 94_77
~:htpAYMENJ^TY~P"E= :~"~"i ';1(J;AYORMS;7ctsiHIERrDB'oWtsBY"fy,~~';:rL;t;?~t,c6NiM'ENTS\'~~,;1j~:~,;0A :~,-,:^ ':, ~ 0 :.'!' "'_ ~.! AMOUNTP AID -l.:<,~: ~ ; "'-,-:, ". -,t"A,J
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Credit Card OREGON ELECTRIC SERVICE 94.77
024853 LLC
TOTAL PAID:
94.77