HomeMy WebLinkAboutPermit Electrical 2011-4-28
Electrical Permit Application
225 Fifth StreettSpringfield, OR 97477+PH(S41}726-3753,tFAX(541)726-3689
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This permit is issued uuder 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
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o Residential 0 Government 0 Commercial
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City:
Reference: I
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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:
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Business name: /-
Address:
City: C
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
ATTENTION: Oregon law requires you to foUow
rules adopted by the Oregon Utility NoUflcation ~ \.
Center. Those rules are set forth In OAR 952-001 /\ ."
0010 through OAR 952-001-0090. You may obtai {\' \
copies of the rules by calling the center (Note: the &.... V
telephone number for the Oregon Utility Notification
Center Is 1-800-332-2344). .
440-25B4-J (9/OB/COM)
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Residential, per unit, service included:
1.000 sq. ft. or less (4) I $134.00 $\1kA . ~
=ditirnal ;e~"lF;Z:'c[r?A~ <0 ~ $ .:8t ,:
Limited energy (2) v $ 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 $ I {fAJ
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 $
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 service~ or feeders section above
Branch circuits: new, alteration, e~tension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I $ 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 q $ 6.00 $BA. D
Miscellaneous fees: service or fee~~r not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) Ii $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2) :,
Each additional Inspection: (I) ., . $58.00 $
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(A) Enter subtotal of above fees aLlJ ( ()
(Minimum Permit Fee $58.00) $ T.ln.
I - . ~ . II [j - 1 $ f Of".
(B) Enter 12% surcharge (. 12 x [A I) ~i
'....1... ~1-HI\f1tl ,1-1"" . vlllRE IF THE WO iK $A-1\ .IJ i)
(e) Teclinology Fee (5% of'[AI) f"":;t"ti'/l-JII'~llll-'-J l/-.lll'~' LJI\RII- In N JT $ rYo J~
_T_OT;\l'..fees and surchargest~:,through 0):
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tu Uti I:' AtJi\NUUNI::U J-UH
ANY 180 DAY PERIOD.
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 8t
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.Us
811-5PR2011-00698
5272 MAIN 5T
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011000820 RECORD NO: 811-SPR2011-00698 DATE: 04/28/2011
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Branch circuits wilh service or leeder each circuit 224-00000-426102 54.00
Permit Fee Adjustment - Electrical 224-00000-426102 536.00
Residence wiring 1.000 sq. ft. or less 224-00000-426102 134.00
Services 200 amps or less 224-00000-426102 162.00
Stale 01 Oregon Surcharge (12% 01 applicable lees) 821-00000-215004 106.32
Technology I~e (5% 01 permit total) 100-00000-425605 44.30
TOTAL DUE: 1,036.62
PAYMENT TYPE
Credit Card
028062
'PA'Y6R,":';;:cA'siAIE:R;!miHoPRER'mml~lijWJmc'oMM'ENTs'!~in'r;I;l~!j:rnti~!iill'Jjf;';Hf;~!mi"mmli~i1!ill~Qii~MPJJ}\tfi~~lb~nilll~\~~ljmjru!ll
OREGON ELECTRIC SERVICE 1,036.62
LLC
TOTAL PAID:
1,036.62