HomeMy WebLinkAboutPermit Electrical 2011-5-24
225 Fifth Street. Springfield, OR 97477+PH(541)726-375HFAX(541)726-3689
DEPARTMENT USE ONLY
Penn it no.:
5/1-01/70
S .Ill
Date:
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.
NOTte
THIS P
AUTHC
COIV1Mc"v
ANY 180 DAY PERIOD.
. 'L:OCAL' (>OVERNMENT ApPROVAG\,,""":C': ':'.
Zoning approval verified? DYes D No
.,,' .CATEGORY,:OF'CONSTRUCnON'..>.\ " ,'. "
D Residential D Government D Commercial
~1E~~JjJ)B;'SITE.INFQRMATIONrjAND1iGo.CA:rJON~'i!h;:;'" ;,
Job site address: 1.. 4/
City:
Reference:
78
15
<, '<,l
';t.tJ ~
S. t/t-ll., -:..~
1.- 'v! 'b'S:
PROPERTY, OWNER
Name: CO b.L-AJ\/6
Address: :s 92 /7 '" LN
City:Tt:;--a..e.eC"O.........~ State: 012:.
Phone: Fax:
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).
ZIP: 97760
Signature:
CONTRACTOR INSTAllATION
Ie.
'1-0
City:
Phone.
E-mail:
CCB license no.: 597'1 i
Signing supervisor's license no.:
Print name of signing supervisor:
Signatu 'To- t. \nSJs , ... law r
follow rules adopted by the ego Utility
Notification Center. Those r sare set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-BOO-332-2344). \
~~.\.~
440-2584-J (9/08/COM)
:~"{:.":V,~;;\~~.~,1Yr~~:?I7,EE~SCHEJ:jQt1Et.lr~:'i~if~~~~;~~~l~~~~W\~~
,Number" o'tinspeciio'ns per it~m' (.) ',' Qty. Cost Total
.',.: ".... ....'.ic. .-_1.' "j'_': .' , .' ~a;. ""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: instal/ation, alteration, relocation
200 amps or less (2) I $ 81.00 $ ~\
20 I to 400 amps (2) $ 95.00 $
40 I 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: instal/ation, 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 ofa 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) $ 55.00 $
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, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
;''1!i~.~;}~tg!'~i~~JHRi~i'~~fAR_~_LiC,ANtfHJ5'E1~~fi;J;:::~;C~:~.~J'?;~.;!::?fl,.ji:;},:it '.;'::.
(A) Enter subtotal of above fees
(Minimum Permit Fee ~S8,QQ)"",,?,< $ ~I
fiS) Enter 12%surcqW&'ikl,1-l<t!6D WORK $ <;,2-
:{0)l\fu ~~~T ISnNOT. '. $ I.-{"!;
~ I
T' 1\. ~~!i~1\f\fhm~Mo.rough C): $ 91( 77
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~OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2011-01170
2415 46TH ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011001320
lDESCRIP.TION
Services 200 amps or less
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
RECORD NO: 811-SPR2011-01170
DATE: OS/26/2011
PAYMENT'TYPE
Check
7503
_,' PAYOR. CASHIER: DBOWLSBY- .
lite electric service
, _ __~.__ __ACCOUNLCODE. AMOUNT_DUE_._ ..-'
224.00000.426102 81.00
821-00000-215004 9,72
100.00000-425605 4,05
TOTAL DUE: 94.77
,.'AMOUNT PAID.
. -.~ ~ . COMMENTS
94.77
TOTAL PAID:
94.77