HomeMy WebLinkAboutPermit Electrical 2002-2-26
225 FIFTHSTREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELE.AL PERMIT APPLICATION
City Job Number 0 2 - 00 ZZ L( - 0 \
3. COMPLETE FEE SCHEDULE BELOW
1. LOCATION OF INSTALLATION
/ h 1~ C AjUP>.L S-.,-:-
~f(cIJ0&-r=iLI D 012. 0;7477
LEGAL DESCRIPTION
17 D3S,'-{Z-:S 02.700
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost SUlll
JOB DESCRIPTION TheJojtQwln9 project as sUbmitteWQQ.;$qE>fto~tnvJ.~
.scr.1A- (Z I. ~ S V:;~~ 6inW~es not reqUire s~llf:~emh~l 500
( / approval JDfl sq. ft or portion
Permits are non-transferable and expire Zoning ~h.x;;;;:
if work is not started within 180 dflrY~ d . 8J, - 0 ').-... Eacli M:l1l11frl Home or
of issuance or if work is suspendeafo? .' ~ ')Modular Dwelling
180 days. Auttlonzed Signature ::iervlce or Feeder
$106.00
$ 19.00
$ 50,00
2. CONTRACTOR INSTALLATION ONLY
B, Services or Feeders
NOTlCQnstallation, Alt~ft'W~f1fEWORK
THISPERll.AnueIrU\W.;.EXP. .. 'lISNOl
7ED UNDER TI-\\
AU. THORlU(J ~R~Sla~AN DrOA
OMME~h'rtps to 460 amps
y 18(J1l9A\{,HJfR~e amps
601 amps to 1000 amps
Over 1000 amps/volts
econnect Only
$ 63,00
$ 75,00
$125,00
$163.00
$375.00
$ 50.00
Electrical" Contractor
Address
City '- Phone
\
Supervisor License Number ~
Constr Contr.yum r
Expiration tate
Owners Name S/E.-i/f!:r.f dnJlI'n C;
I
Uvr~( 5+
Phone bK3 '-3 (fS
D.
One Circuit
Citv
Each Additional Circuit or with Service.
or Feeder Permit $ 3.00
OWNER INSTALLATION
The installation is being made on
property I o\.vn which is not intended
~.".""'."""'..."" D.O. ". _5<.". Ie.,. le.a. s~ ~r..,r.. e...n.. .t....
'-,
Owners Signature\
SS:J --:) _ ~
- \.. -v' ---,
E. Miscellaneous (Service/feeder not included)
-Each installation
Pumpor irrigation $50.00
Sign/Outline Lighting $50.00
Limited EnergyIRes $25.00 2<;-
Limited Energy/Comm $45.00
Minimum Electric Permit Inspection Fee i~~lI'charges
TOTAL
L()
3/5
j;bt>
,...-
5"r 7 )
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Auministrative Fee