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HomeMy WebLinkAboutPermit Electrical 2011-3-9 - " Electrical Permit Application 225 F;fth Street.Spdngfield, OR 97477.PH(541)726-3753HAX(541)726-3689 '.' "'-' ""~ . . - ' -. . .> "DEPARTMENT USE ONLY ~-'. "-',i,' , . . _ . Sp(l;!e(( -OC. '3 bF Permtt no.: Date: 3 - -// 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. IECC,' AL'GOVERNMENT"APPROV AIi,?'-;;~'r{,,,7j'>fi . , ,". '- - " ""'< '--'-- -- -,.- -,- Zoning approval verified? 0 Yes 0 No ;:deA TEGOR'(-;Of, :C()N~TRUCTION'5,il": D Residential ovemment D Commercial l!i'f,.iJiI2t~)lJOEl1fSITEf)INF()RMATIONr_AND~r;:()CArION~~1;:i\jf? Job site address: W ZIP: Taxlot.Oo6 DO OF- ,WORK HY";::>" :,N"<',;:',!": Name: Address: 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). ,~'" Notification Center. Tho 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). ~\)1? . ~ -T'cr;. " I .... '115 PERM IJTHORIZE }MMENCE "Iy 180 D/i: 440-2584-1 (9/08/COM) 1:}~J\S;;~i~1{~#.~t~~r~7Fi,;F;EE9l',s~c.HEJ:).O~E~~~t~Mt~l~~ifit~~~W ',:' .,' .'" ,,'.-.'.' ;'" .' Cost:," Total" ,NumberofjnspeCtio'nsiper iteinO. ....... Qty. .;',"~~3.;"';,. ' ,'cost " . _., '~ I. ';- '.' .. 'le'... ,3",",,:. :- ..,tl ";-,(." '\.'l~'i... '.._ "" , Residential, per unit, service included: 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 (2) I $ 81.00 $$fT 201 to 400 amps (2) $ $ ~ 95.00 40 I 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 $ 40 I 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 pane! 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 no! 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: (1) $58.00 $ ~~ (A) Enter subtotal of above fees 8/ (Minimum Permit Fee $58.00) "I , $ _ "0 i rCl.lj'Ehh!r.l\2o/.Ps'~thl e'/)',- lKll:~ $ 'f7"'7: ) ""!'IC,", 'W'i'n ." CfOS' 'IJ(O)q;echn~l~. :,~er'l' o~i'r/!.o.J/:l $ :IiJroir-AE f~~s"a'~:iS'~;charges (A througb C): $9V77 - -............1"'\ Y t"'cnIVU. I I ; . . . TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth SI Springfield.OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00368 1451 WALNUT RD permilcenler@cLspringfield,or,us ir;i:i:1~':::;lz'~iiti12JIL4fif~{;Acc,o.'U N:tZCODE~ ; ~ 224-00000-426102 821-00000-215004 100-00000-425605 TOTAL DUE: DATE: 03/09/2011 ,~:,.-; '':'".cAMOUNT'DUE.:5:(';;.~:::'.!] 81.00 -'-~- 9.72 4.05 94.77 RECEIPT NO: 2011000431 lDESCRI~TI6N;:c- :'';:';'"'' '.<j'Jr~.Ii)""""''' Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) RECORD NO: 811-SPR2011-00368 t<.; ....",. -,..... ,.'.' ...,.,,,~.,""", . ~""':1,"'-::d'7'i0"'~"=;'"':"~""'O':""-i"'~~""';-;:;""~' .",'.Ff',,~. '..:, ;...... ' -. .' ~ ,.0"'......""",'~i;.".;,.",...,',..::',.;4:;,...",.,... ..... ',' .....,: ..:'......'............0...... T' .. ...".~, ,", .',"'. 2if7.'.~';'.6( :. C j ~MENT lCYPE :',,: '1, "'PAY9Rci.?1fCASHIER~DBOWLSBY0;4~ COMMENTS:jrifrhi!:;'{C~";Ji?:t1tt'.;'~;';.iJ1b~"1ANL~UN ,PAID.. ,; ,,'~V'ot;~Ar$,;h;;2i', Credit Card jim davis city of eugene 94.77 057563 TOTAL PAID: 94.77