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HomeMy WebLinkAboutPermit Electrical 2011-4-21 '-'" Electrical Permit Application CIT\tOF:SPillNGFIELD~' OREGON" . :' .;'. ,',', " '" ~ ',,~;;,~f . -'\1"" '" : ,', . ~ \ I . ,- ....'" , ~ 225 Fifth Street. Springfield, OR 97477.PH(541)726-3753tFAX(541)726-3689 DEPARTMENT USE ONLY S '(l.2J)tf- 00 ~7 Permit no.: Date: -Z(- t ( 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. ATTENTION: Oregon law requires you to fo".~w r~les adopted by the Oregon Utility !'lotlflcatlon Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090.. You may obtain copies of the rules b calling the center. (Note: the telephone y NOTICE: number for the. Oregon Utility Notification THIS PERMIT SH Center IS 1-800-332-2344) A . . UTHORIZED UN COMMENCED OR ANY 180 DAY PERIOD. LOCAL'GOVERNMENT APPROVAL' Zoning approval verified? 0 Yes 0 No , 'C,6.TEGORycOF.CONSTRUCflON'<," D Residential D Government ommereial ~~~,~'tOEt;$ITI:)NF'QRM.A.'rIQNfAN[j!LdCAl;i()N::;'{'W";'; Job site address:. 5707 I-'YIftlN s T ~ S~~ ~ ~'~8 Reference: 1"702 ~'3 '1'f Taxlo!.: 008'0'0 DESCRIPTION OF WORK".......d.. . Dh CI t-c.tA, ,- PROPERTY OWNER Name: Wl'fCa.tve- C".>SS'. Address:Z15/( C 'S.T 5 Ie City: ev-lrt. State: C A 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). s:. II 1S: ZIP: ?S5;'O ( Signature: '1./ 'i 041/ C- 440-2584-J (9/08/COM) :~ ':.' ..c;.,i( :.;,~~t-~;,:~,:';~!Y:~~T;j~1: (/~:f,E:E:' ~~.;s GH E_P.Q~ET'.:i ':~\~:~';r;~;tf9J&\1t~~i~i(.~tf~r~ ,Num~er. o(.inspecti(lris p~ritein.'C) -. Cost Totar . ,,'.' . .,;. ,.. Qty. i .e;J. cost 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) S 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) $ 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) $469.00 S 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 S 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 ofa service or feeder fee; First branch Circuit (2) / $ 55.00 $S-S- Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder ~ot included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, S 63.00 $ alteration, or extension (2) Each additional inspection: (I) $58.00 $ ;~;;f;fJt~~~t~Xg{~1~;Af!eLicAN;r;iUSE\,;j:; :TjC~~~;i;:;~flt~;':,:)~:'i,1,::~: .;:. .' (A) Enter subtotal of above fees $ S-g- (Minimum Permit F(e'$58.0ii)) (B) Enter 12%silreharge (.12 x [AD $ , fr, 1m li'effihlliOgf Fllrl~o,WB 00) $ 2 yo I.",,,, " u~h~lg~s (A through C): $ b 78'f> I;;' fltlflNUUNtU tUli - . '.' f. ... ;. ,". .;:; TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth SI Springfield,OR 97477 541-726-3753 www.cLspringfield.or.us 811-SPR2011-00657 5707 MAIN ST permitcenter@ci.springfield.or.us RECEIPT NO: 2011000772 RECORD NO: 811.SPR2011.00657 DATE: 04/21/2011 lDESCRIF1.T[ON"- "';:4"';,:~,"i;,.:: -:':;.~ ')k:i!~~ J!,'II,cAcCC)(JNLCODE",',;;':;:l'.."", : .'ANiOUNT=DUE Balance of Minimum Electrical Permit Fees 224-00000M426102 3.00 Branch circuits without service or feeder -1st circuit 224-00000-426102 55.00 State of Oregon Surcharge (12% of applicable fees) 821.00000-215004 6.96 Technology fee (5% of permit total) 100-00000-425605 .'__.' ~_2JlO_~ TOTAL DUE: 67.86 ~;+jC:{~'/'~:..Cj)J~IM:g~t~~t;~4~+'t::~;;,jt,;' ;;::' ,~':;l.:.AM~UNT.p ft..IOk~2~"\~~'_{"":,::,~>i':j 67.86 ,iX '~ ':J bP.~Y.M"E'Nj':IY~E)i"'i,,,,:~~ygR~'CAsHfERr[)B6W[SBY'::'. Credit Card everyday electrical 003341 TOTAL PAID: 67.86