HomeMy WebLinkAboutPermit Electrical 1999-12-15
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
;he, fol/owing project as submitted has the tol/ow
a~~~~~'afnd does not require specific land Use'
Zoning lvtZ
Date. 12-/5 -C) ~
97477Aulhorized Signature
726-3769
P.T.F.O'RICAL PERMIT APPLICATION
" '\
l;l (1" Job' Number
CJq/~ 5~
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1. 'LOCATION QF INSTALLATI~_
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LEGAL DESCRIPTION
J 7/t? '2., 2- f) z.. / I tJ 0 ffO
3. COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
JOB DESCRIPTION
lb. tk. Pt.U2'W"lCW. ,4-L.1 J N*
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
$ 85.00
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
$ 15.00
,$ 40.00
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
. (~nstallation, Alterations
Electrical Contractor.~(JI'~ ~tv~~or Relocation:
. ,
Address f~'-{)-~I\"!'1 :J.--<t Cj' '").1.. 200 amps or less
201 amps to 400 amps
Ci ty ~ ... _ . Phone..k.8 to -(p I- l{.., 401 amps to 600 amps
a 601 amps to 1000 amps
Supervisor License Number ~ f..(tj'"7 ~ Over 1000 amps/vol ts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Expiration Date /o-/)/ --C>I
Constr Conte Number 708R'Y
Expiration Date /~'-'3 ()- CO
C. Temporary Services or Feeders
Installation, Alteration or Relocation
"( ~ ~~JJL-.
200 amp~'oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Signa tm:e of Supervising Electrician
Owners Name TOo J) (;; t./e...I4-5.
Add re s s -L) ~).-Lf' f {A--fC.1Z11'f--:!.L f!L ~
Ci ty 5pi!{;JjC~ Phone ~ ~l(?-;:foJ>J7
OYNER INSTALLATION
D.
Branch Circuits
,"
New, Alteration or Extension Per Panel
One Circuit ( $ 35.00
Each Additional
Circuit or' wi th Service
or Feeder Permit -L $ 2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20~00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 37. tJ70
'7% State Surcharge 2. IS?
3% Administrative Fee I,t/
TOTAL 4~ :7 ()
L V"
~ Owners Signature:
-----------------------z. --------------
DATE: 12-/ / ~ 5' y ._ _
RECEIPT #: '~? 4,,4--.J. /
RECEIVED BY: //~--: ~
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