HomeMy WebLinkAboutPermit Electrical 2011-7-14
225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+ FAX(541)726.3689
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.Eiectrical Permit Application
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Tbis permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180
days of issuance or if work is suspended for 180 days.
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Residential, per unit, service included:
mercia!
ION"",: 1,000 sq, It. or less (4) $134.00 $
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Each additional 500 sq. ft. or portion $ 25.00 $
thereof
q 1-<{ '1-1\ Limited energy (2) $ 32.00 $
,zsl c:>C Each manufactured home or modular $ $
~'i5bs,g~;~;;:;~!' '() dwelling service or feeder (2) 63.00
Stn'ices or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
;'0;; 201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
~110 601 to 1,000 amps (2) $205.00 $
'1t~ln Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
:">.U "'- Temporary senrices or feeders: installation, alteration, relocatiO/)
roperty 200 amps or less (2) I $ 63.00 $ 6<
is 201 to 400 amps (2) $ 87.00 $
nt.OAR
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services Or feeders section above
'F'''';, '~, Brancb circuits: new, alteration, extension per panel
a Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit $ 6.00 $
.-!h fS1p 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 nol included
Each pump or irrigation circle (2) $ 63.00 $
I1..U.>""- Each sign or outline lighting (2) $ 63.00 $
,~-' Signal circuit or a limited-energy panel,
alteration, or extension (2) $ 63.00 $
Eacb additional inspection: (1) $58.00 $
i', k"~~~{l::llij.fI$.'8el.lrC;6lN"~l1S~~:t~];~+K~:tt +;
(A)fdiliterIsUbi~UIJ'6N.ii.Wf~e~Y 1I1~ VI ">lV" r"') 63
t" . ~"i\!f$ hose rules are se.tort~
(Mi\iJtfliHri\tP!I'\"~~1')c,~,~~"om'n"Clh OAR 95: :-001-
~47.~i\lIfffii'!'l1{,f;,!gi~ [b"J1Jies ot the ru es t:s' 7 Sb
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rv<\i\.\ . ,..~ I a:l:~., I\I",hf,I" :.iinr~
w'...nr 1i m~ U\t;;\..lUI """'''''J .. - $ /7e_
TO'F . fees an + ~ ~~a~~~\(~;t~rQ~g~1 <;:):
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""'+1..0c::ACj30VERNI\IIENf;iApPRovA~
Zoning approval verified? 0 Yes 0
CATEGORy.QF';C::ONSfRlJC::TION:
Reference:
Name: J.f..1I:-'{()C?-' ~{..oI'-1..?)
Address: 'l<{, '( ":Iv..) (.., Lt\c. c"- "L-
City: ~C'-<:>..J.\'l State: 0 <L ZIP:
S'n. - $1510 Fax:
E-mail: f{c:N t) Q.\~so,.J @ rw/)~-Ifot-,;
This installation is being made on residential or farm p
owned by me Ot a member afmy immediate family. Th
property is not intended for sale, exchange, lease, or re
4 79.540(1 ).a~:9.5jJ!<!1,.
Signature: 7" /' / C -
;'CONTRAc::foR'INSTAIDTION;
Business name: ~ocnJ ,~ M<...~
Address: 2r~<( -:;....s C...Lrttl....Al-
City: ~~,...~ State: <0 L ZIP:
Phone; ~I-~c. - .;r<to
E-rnail:
CCB license no.: Ft'Z. Sl.<2 BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
MOIICE: XP\RE 1f 1liE WORK
THIS PERMH SliA~~ ~HIS PERMIT IS NOT
AUTHORIZED UND,S ABANDONED FOR
COMMENCED OR \ C"\O 1
ANY i 80 DAY PERIOD. ~
C\
440-2584-) (9!08/COM)
~
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth $t
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-01365
4912 HOLLY ST
permitcenter@ci.springfield.or.us
l PAYMENJi'fYPE',' ".EAYO~ "cII.SH'r""'DBOWLS~Y;;;V:& COMMENTS>_,.
Credit Card HAYDEN HOMES LLC
RECEIPT NO: 2011002023 RECORD NO: 811-SPR2011.01365 DATE: 07/14/2011
U5ESCRIIH!OI\l" ':1 +0~;:;rfii'f'. 'ii:.'-, ii&:c",:~1+;;i-~ACC0l!JNJ~cobE:. ,: "7'*: . !AMQUNm,DUE'q, . pI7"\1
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 7.56
Technology fee (5% of permit total) 100-00000-425605 3.15
Temp services 200 amps or less 224-00000-426102 63.00
TOTAL DUE: 73.71
. ,,~'::Iif.:\ '. .AMOUI\l'F....F.>.AID... ~Cf:.. p, .j
, -~ . ~",.,"
$73.71
016682
mOTAl PAID:
$73.71