HomeMy WebLinkAboutPermit Electrical 2011-8-18
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Electrical Permit Application
. CITY. OF; SPRllSGFJ'RlJD, @R,EG()N' : ,"
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225 Fifth Strecl.Springlicld. on. 97477. PII(541 )726-3753. F^X(541)726~3689
. DEPARTMENT USE ONLY
Permit no.: 51 1- I Cj 2. Z-
Date: '711 b I> I
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days'ofissuance or if work is suspended for 180 days. 1
LOCAL.GOVERNMENT. APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION I .
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City. Ie..
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ESCRIPTlON OF WORK
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IZe"7'lOL/
PROPERTY .OWNER
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State<01-- ZIP: et1l..fo
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City:/::
Phone:
E-mail:
This installation is being made on residential or farm property 1
owned by me or a member afmy immediate family. This I
property is not intended for sale, exchange, lease, or rent. OAR!
479.540(1) and 479.560(1). '1
I
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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440-2584-1 (9/08/COM)
FEE SCHEDULE
i\uriJber of inspections per item () Qtv. Cost Total
ea. cost
Residential, per unit. sen.'ice 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)
Ser\'ices or feeders: installation, alteration, relocation
20~ amps or less (2) $ 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 $
Temporal")' ser\'ices or feeders: installation, alteration, relocation
200 amps or less p) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
40 I 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 of a service or feeder fee:
Each branch circuit I $ 6.00 $
b. 'fee for branch circuits without purchase of a service or fceder fee:
First branch circuit (2) , $ 55.00 $$'S-
Each additional branch circuit 10 $ 6.00 $~O
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) . $ 63.00 $
Each sign or oulline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
APPLICANT .USE
(A) Enter sublotal or above fees $ (f)
(Minimum Permit Fee S58.00)
(8) Enter 12%surchargc(.12x [A]) $ 138E..
(e) Technology Fee (5% of [A I) $ r'2..:J"
TOTAL fees and surcharges (A through C): $Is'i~
;
www.ci.springfield.or.us
I
TRANSACTION RECEIPT
811-SPR2011-01922
I
132 5 32n~ ST
CITY OF SPRINGFIELD
225 Fifth 5t
Springfield,OR 97477
541-726-3753
SPRI~G. ~E~
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':~
,.,\ OREGON
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011002321 RECORD NO: ,811-SPR2011-01922
lDESCRIf'TION ,-;-:'ACCOiJNT~CODE
Branch circuits without service or feeder - 1st circuit I 224-00000-426102
Branch circuits without service or feeder - each additiona~ 224-00000-426102
State of Oregon Surcharge (12% of applicable fees) _--I 821-00000-215004
Technology fee (5% of permit total) .! 100-00000-425605
TOTAL DUE:
DATE: 08/26/2011
", AMOUNT:DUE
55.00
60,00
13,80
5,75
134.55
AMOUNT PAID'
"
134.55
UJ.lXMENTJYRi:
Check
8924
.P.J.lXOR." fASHIER: CCARPENTER '
WHISKEY HILL ELECTRIC INC
'COMMENTS
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TOTAL PAID:
134.55