HomeMy WebLinkAboutPermit Electrical 2011-2-24
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225 Fifth Streett Springfield, OR 97477tPH(541)726-3753tFAX(541)726-3689
r." 'DEPARTMENT .USE ONLY
".:
sIll ZOI(-OOZ. ., '7
Permit no.:
Date: 2~'Z
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. -
Signature of signing supervisor:
ION: Oregon'
follow rules adopted b aw requires you to
.Notlflcation Center Th Y the Oregon Utility
In OAR 952-001-0010 those rules are setforth
0090., You may obtain c~ou9h OAR 952-001_
calling the center N pies of the rules by
nUmber for the Ore' g( otue:, the telephone ~ NOTICE'
Con tJi/ty N t'f' .
enter is 1-800-332-234~ IlcaUon :J THIS PERM
. ). I\'~ AUTHORiZE
(J COMMENCED OR is ABANDONED FOR
ANY 180 DAY PERIOD
. .
".' .L!OCAV'GOVERNMENtAP.F!R.OVAt::;;;A'\I~;~,~r;'\y,y
Zoning approval verified? 0 Yes 0 No
;;b'.\,,:i,iCATEGORYiiI0F ;',CONSl'RUCTION:A- , ,'..
D Residential D Government -ErCOmmercial
~~J1Y:"tOEliSI:rEj;INFOR.N1A:r10I'-lr:'AN[jI;:CO.CAT:ION~~~1P'i',:
Job site address: S t- -
City: 01((., ZIP:
Reference: Do 2. 3'2. '3 Z. Taxlot.:O J 000
,N' DESCRIPTIOWOF .wORK;'~',
5~vc.. ~e-COI-\""'&""C.-\
Name:
ZIP 9'"1l( ,
City:
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).
Address:
City:
Phone:
E-mail:
CCB license no.: 3 s~t S~/
Signing supervisor's license no.:
Print name of signing supervisor:
ZIP:
~
440-2584-J (9/08/COM)
t;;;.":1:!}:;;;1iA-{:G~i!<;?B.m:~(~i(:r"i FEE'!;,; SC. :H"" "EDU' - i~Ei:"6~fr;~(<<i{:X!k~~;'~~,~f:-'t!~'t~
,'._, <<.':.-_:~c.'ln/_h~,,""t!:';'''',l,<:'.. _'!\>. .... '_.' _.1..:.: -t_,J."~':;':'IO!<:-':~'R',;,,,!-,,_'J.:,'tl-,1nVt:"':i'~..
,Nu~~ero'ii~;p~cti~~~p~[~tIn,' (\':;:. Qh. ,,!1~R, ..~~~f:
Residential, per unit, service included:
1,000sq, ft, or1oss(4) $134.00 $
Each additional 500 sq, ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 53.00 $
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) $459.00 $
Reconnect only (2) I $ 53.00 $ /.. c::.
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
$ 63.00 $
$ 87,00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration 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)
Each additional branch circuit
$ 55,00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
$ 63.00 $
$ 63.00 $
Signal circuit or a limited-energy panel,
alteration, or extension (2)
$ 53.00
$
$
Each additional inspection: (1)
$58.00
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(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
$ b"f.
$ 7 ~(;
$ :JI S-
$,"(: 7(
~
(B) Enter 12% surcharge. (1}.xJA])
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I ) TOiFAJ",fe.;s; a:';;j:"s~ehj,~~~ <A:iiuough C):
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-00297
171 S 41ST ST. APT 1
pe':lT\ilcenter@cLspringfield.or.us
RECEIPT NO: 2011000348 RECORD NO: 811-SPR2011-00297 DATE: 02/24/2011
IDESCRIPTION';.'. .:. ,,'4'V~': .^'\r;.,Q'E."'." :'",(-, ,:,~-,J:.': :'~'};" 'ACCOlJNT'CODE"k";:,;S'::i."..,iil.MOUN'rbuE' ..;. "1
t .. _ . l..~_.._.~ ,~~,,",,~,_~,,_,,,,,,,,,~~,,,~,_,,,..-,,,-_-,-,, .. .... 'k.... _~...J:__....~#___ .. , _ ___~....J
Service reconnect only 224-00000-426102 63.00
State of Oregon Surcharge (12% of applicable fees) 8?~-00000-215004 ___2~.6
Technology fee (5% of permit total) 100-00000-425605 3.15
TOTAL DUE: 73.71
'_. ,C' ...." ;::~' P"AMOu.N:r:F>~ID
73.71
I~'PA VMENT 1:YPE "
Check
1965
,~,,'~~PAYOR;J::tcAs"HiEjt:D'BOWLSBY~~<~ ~,:h"~/F'~cdMnlrENTS '; -c'
kidd and company electrical
contracting
~... '"
,
.1}
TOTAL PAID:
73.71