HomeMy WebLinkAboutPermit Electrical 2011-6-22
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Electrical Permit Application
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225 Fifth Street. Springfield, OR 97477'PH(541)726-3753'FAX(541)726-3689
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Permit no.51 / - 0 / S 3 (
Date: b - '2 Z -/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.
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Reference: 0 S:5 Taxlot.:CC>/O C
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Name: ~(!O~l
Addiess: ~ e:,1\"T-a..J
City:
Phone:~~ 1#-4'-1 to
ZIP: tf1tf7]
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).
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Signature:
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Business name: 8':. Aw
Address:
ZIP: q""llfOl.,..
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
ATTENTION: Oregon law re6~.~e~X~i:i~y
follow rules adopted by thr~les a~e set forth
Notification Center. Those hOAR 952-001-
in OAR 952-001-0~t~~~~~~i~S of the ruies by
0090. You may 0 ate' the telephone
calling the center. (N Utility Notification
number for the. ore8g0o~_332_2344)..
Center IS 1- ,
. .
Residential, per unit, service included:
1,000 sq. ft, or less (4)
Each additional 500 sq. ft. or portion
thereof
$134.00 $
$ 25.00 $
Limited energy (2)
Each manufactured home or mo'dular
dwelling service or feeder (2)
$ 32.00 $
$ 63.00 $
Services or feeders: installation, alteration, relocation
200 amps or less (2)
20 I to 400 amps (2)
401 to 600 amps (2)
601 to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
$ 81.00 $
$ 95.00 $
$158.00 $
$205.00 $
$469.00 $
$ 63.00 $
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
Branch circuits: nelv, alteration, exten.sion per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit
$
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or ontline lighting (2) 1- $ 63.00 $ ('2"
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
440-2584-) (9/08/COM)
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-01539
3660 GA TEWA Y ST
permilcenter@ci.springfield.or.us
RECEIPT NO: 2011001726 RECORD NO: 811-SPR2011-01539
lOESCRIF1,'nON ,;~:~:::-' u "J; :,;:' ,"'"IF""': ii, i":"'> ~ ';'-l\CCOUNT"COOE5""n,'"" ,:
.,.".S!\1n o~ ou~i".".ligh!i."~_ ___,_______ ---3_24-00000-~2~______
__ . _~tat". ~~ ~~e!!.o-"-~~rc~~,,J23'(o,o_f app"c:ab1e fees) 821-00900~~,___~___________
_____!~ology f':El.\:''''': of permit total) 1 00-00000-425605
TOTAL DUE:
" PAYOR. 'cAsli'ER:'DBoWLSBY (,:' "'.',-,,'COMME'NTS;'."';l%,)"',[';:2;;,;,,/,: '
" ~. ._,~. ,... ~':'" .,.".....'", .~......M
E S & A SIGN CORP
DATE: 06/22/2011
AivloUNT_DUE.~.J
126.00
15,12
630
147.42
,AMOUNT PAID
147.42
1
I;PAYMENTTYPE'
Credit Card
022772
TOTAL PAID:
147,42