HomeMy WebLinkAboutPermit Electrical 2011-5-26
225 Fifth Stree'. Springfield, OR 97477. PH(54l)726-3753. FAX(54 1)726-3689
Dale:
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.
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.Numb,er ofinspecti?~s per .it~~J)'Qty. ;~~~~ ~~W
Residential, per unit, service included:
1,000 sq, ft, or less (4)
Each additional 500 sq, ft, or portion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$134,00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95,00 $
40 I 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) I $ 63.00 $63::
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
40 I to 600 amps (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
CONTAACTOR INSTALLATmN -
Business n'l'l e: () lJ Y f( 1/ n f 00
Address:,~ r 0,( {p Of -,
City: \Af'tJ. ., r V \..; State: (i "<-l I ZIP:f1"/Y Y'1 b. Fee for branch circuits without purchase ofa service or feeder fee:
Phone: ~ 'I.j/J /"-'7'1v I Fax~ fllll ") First branch circuit (2) $ 55.00 $
E-mail: I I I Each additional branch circuit $ 6.00 $
CCB license no.: I ~( n l.) V( "I BCD license no,: 1 () LJ lJ.].;.lr Miscellaneous fees: service or feeder not included
Signing superYis~r's license n~.: \ L/... 7 7.. f . ~ II Each pump or irrigation circle (2) $ 63.00 $
Print name of signing supervisor: \ I..!.... . v f/ ,II Each sign or outline lighting (2) _,,$ '63i\l~ $
Signature of signing supervisor: /'\ rT '" \TI'f7r, '\\ n '\1 \UVI Signal circuit or a limited-energy panel, '-t' ~~~~Q)-{ .$
\ ......, ~ J\J\J...:L.JJ '\ alteration, or extension (2) _<I" \ 1'- _ ,~\~
~ . au to Each additional inspection: (I) O\~ \'~WtsSJlo $
ATTENTION: Oregoi\la~ reqUires y .. ,,' "'''j,,"<;.,,'r.~ --,.'. " ~i"""-:- Co. -],'v.v.",.... ^"v'. '.'- .
~~i~~I~a;~~~~:~~~~e1h~~~~I~~~~~~~!~;i~ ~~;...~::~~~~~; ~;~~:;N~~ E~'~;y3;';:1';;;c;i::.~;..:
in OAR 952.001-0010 through OAR 952 001 (MI"'t'1.um~P~r#~~E~$B~<M1)~:' $ b <;..
0090 You may obtain caples of the rules by ~,>" ,.,;:;,\V -\lY ~~v 7S'L-
'. (Note' the telephone (B) Enter,12~ ~rcH~,gs;(.12 >sif,t>')) $. ~
calling the center. . T r I'V ,I" ' '"
number for the Oregon Utility Notllca 10M (C) Technol,!2gyXee (~~1>l9flA]) $ ',3.15
.' Center is 1-800-332-2344). ~)V ~\ '\ TOTAL fe~s';"',~d ~.i'rcharges (A through C): $ 7'<:. ~ '
\9
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
$
440-2584-) (9108/COM)
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- '\ OREGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-01185
2080 5TH ST
permilcenter@ci.springfield.or.us
RECEIPT NO: 2011001325
lDES.CRIP..TION
Service reconnect only
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
"F-
RECORD NO: 811-SPR2D11-Dl185
.- AC.C.01.JNLC.ODE
224-00000-426102
821-00000-215004
100-00000-425605
TOTAL DUE:
DATE: OS/26/2011
. AMOUNT~b.UE
63.00
7.56
3.15
73.71
, AMOUNT PAID _ _~
73.71
L_P.AXI'!I~NTD'.p'E_~P.~Y.oB~SHIER::OBOWL~BY~_____~_ ~.o.r!LII'I~NTC
Credit Card BURRELL BROS ENTERPRISES
04525d INC
-,
TOTAL PAID:
73.71