HomeMy WebLinkAboutPermit Electrical 2011-3-24
225 Filth Streett Springfield, OR 97477. PH(541)726-375H FAX(541)726-3689
DEPf.RTMENT USE ONLY
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PermIt no.:
Date: 3 - ;?-q'-"- JL
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.
.....LOC~L:, GOIIERNMENTAPPROVAl',',;i' ....
Zoning approval verified? DYes DNa
," . ....CATEGORY'.OFCONSTRUCtloN:.:;
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o Residential
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Job site address:
City:
o Government
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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).
Signature:
..CONTRACTOR INSTALLATION
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Address:
City:
Phone:
E-mail:
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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440-2584-) (9/08/COM)
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.. ,'" ,'; . . '.. Cost Total
N~m~er; o(j~spectio:ns p~r I,tern' C) " Qty.
'__ ,'" '-'.' ." "c,,'" '. " 'I.'; .~~:- cost
Residential, per un.it, 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 $ 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 \ ,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
Bra~ch 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 fe'edeifee;
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 il limited-energy panel, \ $ 63.00 $\O~' ~
alteration, or extension (2)
Each ai:lditional inspection: (I) $58.00 $
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(A) Enter subtotal of above fees 'ut> y $ ~\:
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [All $ r"\.5 lO
(C) Technology Fee (5% of [All $ ~ .~ D
TOTAL fees and surcharges (A through C): q~. -:r
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2010-00794
3266 GATEWAY ST
perm itcenter@ci. springfield. or. us
RECORO NO: 811-SPR2010-00794 DATE: 03/24/2011
.;~.~ ':"'i::";":I€O:::;'~~"".:LAccbuN:t:C6DE",_;,2.: ~. -'LAMbON:n:DUE}' ........~:l
224-00000-426102 63.00
----_._~...~-----'.~.-
821-00000-215004 7.56
100-00000-425605 3.15
TOTAL DUE: 73.71
GPAYMENITYiiE:::'~..J';"PAYbR;;:2ASHIER"KKAUFMAiE~~4:;;;&:" COlVrMENfs~:',:,: .;'\;::: .' ,MMOUNTPAID .;:.,-
Credit Card Odyssey AV 73,71
060344
RECEIPT NO: 2011000545
!DESC;RI~TlbN.0. y '.::S:.;;'~
Other Limited Energy
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
, '.1
TOTAL PAID:
73.71
.