HomeMy WebLinkAboutPermit Electrical 2011-8-29
225 Fifth Streett Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
'. bEPARTMENT USE ONLY
Penn it no.: 5//- D / b Z S
Date: 7-Z i-I/
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. . .
'. :i;lOCAL;GOVERNM ENT 'AI'PROVAl':""';n'.'",,,
Zoning approval verified" 0 Ves 0 No
'CATEGORY'OFCONSTRUC1'10N?
esidential D Government D Commercial
&~1%/:!J.OBASITE:;INI:QRMA;rIONi!AND':I.:iQ:CA.TION~ii+";;P
Job site address:. b 9 7 S S
City: ?p:b State: ~ ZIP: 7C(7.
Reference: 702. 3 S:SZ Taxlot.:oc>ZI7
. DESCRIPTION OF WORK> ,.,:/",...,
~,.........L C -~.....
. PROPERTY OWNER ,
Name.> Ii o( CC-
Address: b '7 $ -\-
City: S'~f=~ ZIP ?";X(?lI
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). .
Signature:
. ,CONTRACTOR INSTALLATION
Business name: E'I\S1SIDE (;f...t,c.t{?JC
Address: "3~JS3 BOSCAGE L/J.
City: 5f~W State: oR. ZIP: q11(7~
Phone:S'l[-1'/./- I V"lltf Fax:SVI-736 y.q {.O
E-mail: R{(:{Ct;;f>.<;iSIO€ Ql'r;,/{OO.CM"1
<;:CB license no.: 1 It? 7 (J BCD license no.:,J.() -'{ () 5' e-
If. 7:27 5
ROG-Gf?
Signing supervisor's license no.:
Print name of signing supervisor:
Signa~iDllI~
o I.~w r~les adopted by the Oregon Uti lit
Notification Center. Those rules are 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 1-800-332-2344). W.\\
~?
~\j:\
440-2584-J.(9!08/COM)
'~;\\:_~.,'i:~Nii,:;~~\i':~t,~~m,i::I{:~'~I7,EE-~:SOR EJjLJl2E~(,.\i:i:rW~1~1~:HFf~J;~11t~!~:~:{;~j:\:
. '" ..
'.. Cost Total
,~~~~~r' of, ,~sp'~~ti?:'~.~ ~e~._~t~_,~: () . _ Qty. .-: ~~:. ~ost. '.
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 $
601 to \,000 amps (2) $205.00 $
Over \,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
20 \ 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 Dr feeders section above
Branch circuits: new, alteration. extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
I
$ 6.00 $
b, Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional branch circuit
( $ 55.00 $.s~
Z $ 6.00 $/2
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 Ii~ited~energy,pa,~,~,l,::. ~~:'!"<~ln..."i-6~3 0,0
alteratIOn, or extenSIOn (2) .:'~.,:t..".. ..,,\\\'{"\""'.... ',~.
Each additional inspection: (I)' ,(."\'? \:.~ 58)0
>. "";;'~1\'-"'" .,,' 'A' rinLiI"~~
'if i;\"-1\'T;:~~til1i~~:~ b~,,;c 0:;;, t:' rf~r~
(A) Ente;subtota!wbe!~~ r::,~~\J'.,:
~~~m ~r~li~~'$s{!'l\J-~\) "
~(BiJ-'lRi:-I'.t~~btc'5~fi ",[A])
",. ,\\\'
(C))ie'~lin'l'€~" of[A])
TO~:~rl\f~~;~rtd'Surcharges (A through C):
\>-w
$ b"7
$ ~ott
$ 37)-
$ 7J? 'J?
,
SPRIN.GFIE.L~
~L_.
;;~.." eti
" \. OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2011-01623
6975 B ST
CITY OF SPRINGFIELD
225 Fifth $t
Springfield,OR 97477
541+726.3753
permitce nter@ci.springfield.or.us
RECEIPT NO: 2011002335 RECORD NO: 811-SPR2011.01623
lOESCRIF1IION" - . '.,.... ' . . ..': .----=ACCOUNT~CODE
Branch circuits without service or feeder -1st circuit 224-00000-426102
Branch circuits without service or feeder - each additional 224-00000-426102
_.State of Oregon Surcharge (12% of applicable fee~l. 821-00000.215004
Technology fee (5% of permit total) 100-00000-425605
TOTAL DUE:
!.)1AXMENTIXEE ._._PAXOR~.~HIER: DBO.l'!!<CSBY' c.. ..__~C.OMMEt.I'r.S' .
--..- ----.-.-- ---.--------.-- - -------- ---_.._--
Credit Card EASTSIDE ELECTRIC INC
04578c
DATE: 08/29/2011
- AMOliNT.DUE '-1
55.00
12.00
8.04
3.35
78.39
AMOUNT PAID ~J
78.39
TOTAL PAID:
78.39