HomeMy WebLinkAboutPermit Electrical 2011-3-9
225 F;fth Street. Springfield, OR 97477 tPH(541)726-3753 HAX(541)726-3689
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Date '3-9~20((
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? 0 Yes 0 No
. ,.";iCATEGORY;,~'c)l;izCON$"fRUCmION;'~l,." -",
I~esidential I 0 Government I 0 Commercial
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Job site address: !J..., ~ \ r. I yo 1 (')\ <.. {r B
City:Sl\r;M ,.IA State:Or. TZIP'"":1"1:q
Referenc\: \1'::fl-<1;j \ ~ 1 Taxlo!.: \' t'VX.J
..' tlESCRIT'TION. OF- V\lORK,i!/,li:tr~j;~;! ;;;. "':~
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I PROPER:rV OWNER ,. '"
Name :Q-l-" \\\1\..1 ("';\\)~\VM" \T';,!
Address: '3llf'l r----..r \,..,1.... ~ D
City:~. State: 0..-. T ZIP:
Phone: .#41 . (llC ?,\ ~ \ I Fax:
E-mail:
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I. ) Thisiiristallation is being made on,residentialhor farm property
Tt \ owned by,"me orja m~moel?dfD\y irrHn~'di'a't~.family. This
,_p'rAP~:w;is\n~~,lr:t~~d~q:,(9r ~al~l.:~~.ahange~li~ase, or rent. OAR
A~ ;:,7~!~~~/~DaCf~i~7fgmDONED FOR
C ._~lglla.!ur...e;:" nrnlnn
Ai~ 1 IOU .Uf'\"'c6Ii1fRActOR INSTALLATION
Business name: II ',I/"\ I ."
Address: 5?c ,I '-' . _"-bon
City: ~.. _. J State: at . I ZIP:Q'l4\) \
Phone: 5l-H .~\... ~iz,1 I Fax:
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E-mail:
CCB license no,: \'14-.'"'\'5<\ I BCD license no.:dD-"l4$ G
Signing supervisor's license no.: ,:;\,"""" r
Print name of signing supervisor: ~ I - ,--'( -~-
Signature of signing supervisor: SL. A (1\ - .
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon .Utility
Notification Center. Those rules are set forth
mOAR 952-001-0010 through OAR 952-001-
lIfOOirr. You may obtain copies of the rules by
m:'.ing the center. (Note: the telephone
1Fl1!l~...Dhr f01 :he Or8gol1 Utility Notification
rt,;ncer is. 1-800-332-2344).
440-2584.) (9/08/COM)
;:\:~~j::~'i.ri~:~:,~:~~~ji;:;;~'i\i~i.~~f{F,;EE~:SCH r:D,LI l31;~0~~j~~(~~f{~~~~~I~13t\:~!
,Nurriberofi~;p~~tio'ris p~rii~rn()'~, Qiy. . Costi I Total
': ""c. ,.._' - .!;,:..<:-"_.;-":,;,-,,,,,-,".J~~~_"_" ;:~ea.t;' i:'co_st.
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 iJD
200 amps or less (2) v' $ 81.00 $ k/
20110400 amps (2) $ 95.00 $
1\ 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 $
401 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 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 $
5
Miscellaneous fees: service or feeder I!ot included
$ 63.00 $
$ 63.00 $
Eac~ pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (1)
~
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of [A])
TOTAL rees and surcharges (A through C)i
$ 63.00 $
$58.00 $
~1i!~iii~i5:ili3i1Y:o :'::',
$ II I-
$ -.s:
$ IS
f) 4. X
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-00374
3110 ORIOLE ST
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011000437 RECORD NO: 811-SPR2011-00374 DATE: 03/09/2011
[DESC RI~TION';";;~,*,~~ ,"'i'.= ' ,,:.~' ~+;~f;l' "};+>~~'rIJ)..~j;a~ ',fAccoUtili:cODE+::!5;l2 !ttI"_;~,~';:;AMOl.ltiltDl.I E':;~ '~., .' -J
Branch circuits with service or feeder each circuit 224-00000-426102 30.00
224-00000-426102 81.00
821-00000-215004 13.32
_._-,
100-00000-425605 5.55
---....-. ----".._,.."..~
TOTAL DUE: 129.87
~~AXMi=-NTiYjJl :::il4i'p AXQ1%~CASHII'R' NMACHADo,c",i"';!;.tdz'"'COMMi"N:fS: ;~_~-,;t:l::h!::i..i::.-,-:;:!.~MO!LNT;P AID~ . j ,;;c:~(_,,::, J
Check KNIGHT ELECTRIC LLC 129.87
3041
Services 200 amps o"~ess_,
State 01 Oregon Surcharge (12% 01 applicable fees)
Technology le~.(5% 01 permit total)
TOTAL PAID:
129.87