Loading...
HomeMy WebLinkAboutPermit Electrical 2011-5-31 Electrh;~1 Permit Application 225 Fifth Street. Springfield, OR 97477+ PH(541)726-3753+ FAX(541)726-3689 " .,,;.;.. ". ,-, . DEPARTMENT USE.ONt. y Permit no. ,) / I - 1:2"3 I >--n/ Date: /--' 1/ 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. . , LOCA,L:.GOVERNMENT APPROVAL Zoning approval verified? D Ves D No 'CATEGORY'OF:CONSTRUCTlON '. City: Reference: PROPERTY. OWNER Name: 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 INSTALLA,TION: Business name: Address: City: Phone: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: 440-2584-J (9/08/COM) :: -;: i:::::,~; ,F ;;;~,i:.t/!,i;,~';:>r~t.EE'~SC H E_[:)Q lJE;7,,:.t:"~ ~'f,~~~i~.i}i!i;~~~~~~~~f~~~:' .Nu~ber' of im;pecti.~'ns .~e.r .it~m.~) Qty. Cost Total' >~a. 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) $ 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 $ 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 $ 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 pane! a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit $ 6.00 $ p. Fee for branch circuits without purchase of a service Or feeder fee: First branch circuit (2) -/ $ 55.00 $t)5- Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder ':lot included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a Iimited,..;energy panel, $ 63.00 $ alteration, orextension (2) Each additional inspection: (1) $58.00 $ ;;i\ff;'.,.','*,}f:{~~:~1~~;:;';~~t~:';;~~(AP.J~j3tANta-.{J'S.Ei')'.i~:' , :}) i:,:;';.; .' (A) Enter subtotal of above fees 5g~ (Minimum Permit Fee $58.00) $ (B) Enter 12% surcharge (.12 x [A]) $ 19t, (e) Technology Fee (5% of [A]) $ ?, 9() TOTAL fees and surcharges (A through C): $t/; 7 ,J(J" ~P~I.ilG:..EL~ ~h... -,-, "-'>L 5.," ~ .""~ "OllEGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-5PR2011-01231 614 G 5T CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permilcenler@ci.springfield.or.us RECEIPT NO: 2011001372 RECORD NO: 811-SPR2011-01231 tDESCRIP..TION' :,",-". ".'';.-. ,,-"C- ~. ,,"0M,"&;",'0.\l,\ccou-r\i:T~CODE;:'-:.'- Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 Technology fee (5% of permit total) 100-00000-425605 TOTAL DUE: DATE: 06/01/2011 I_PAYIV!E~LD'P..E-,-- _~!\Y.o!L C"SHIS~ CCA~E!!.TER~_ .:.....-.c.::COMNiE!-I:rS' r Check Livewire electric 013606 , , ,:/':"AMOUr-H-DUE 58.00 6.96 2.90 67.86 AMOUNT PAID , il --.-"--. 67.86 TOTAL PAID: 67.86