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HomeMy WebLinkAboutPermit Electrical 2002-7-16 " 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 .' ELECTRICAL PERMIT APPLICA nON , {J' '""'"\ ' TF:P.NS#:Oi -0009945 City Job Number cA ()C) r- ~~J.Q:~ 16l ~OQ? , , , nMI I\LLu.L $ ,O-J.L:J 3. COMPLETE FEE SCHEDULE BELOW CHANGE: ' Cf~SHIER: 001 ~. LO ',TI01j..pF INSTA!-~],~. ON ,J . I ~ t..j {/ ('1.0 /?tC.P LAL , ..............,~. LEGAL DESCRIPTION " '" ) J 1 t:> 3 ~-S- J;l.. I,S'fi4O V A. New Residential-Single or Multi-Family per dwelling Unit. , Service Included: Items Cost Sum )9~. ESCRI,PP)3I 'ON,p _. ,~)..' <-, " 1.,000 sq.ft. or ~ess , '7::) ':IJUh/'/ ~A/,lJ cSerueL4 - Each ~Wi\Jtttit'%oO '1/111 ,vo~ ~M-t-C;rCII<<!-, II1.tk/I.iP\t\(~tJf..e~~t Permits are non-transferable and, expire '",Q ?foiec ,'\e\.\0\\ f. 1l1'ereof ,,' , if work is not started within 180 d~\o\\O~~d: OOE;" "'~"f-...l2- Each M~e or of issuance or if work is suspended~il\~~\la\ ~-~o~ ~ 180 days. e.?? 1.;~~~_~..&,...,~ ~ or Feeder , 2. CONTRACTOR INSTALLAnO~~ . ,~IS 'ces or Feeders " ' , ' I.lI.J\'t.\:OO SlY" _.("jIlstallation, Alterations or ~Iectrical ContractorQAI./L 0>> ~/e/ fN,Relocation: Address IJ,o,:BO/' 2-315 tj NOTIC!![ ~~flL Phone -;,; ytf-'/f:d THIS ~~ ~Io~~A~~P.1Fi~ IF B AUTHOhlZED U ~'OtR~'P~ , ' CdMMi~rnMS ANY 180 QAVPER10 . Constr Contr. Number ~~ f1 ' ',Expiration Date S.,. / ?t - 2/)c;t/ $106.00 $ 19.00 ,$ 50.00 AT4Qf)rampsl@r\~gon law requires you h$ 63.00 foll@()Jllutw.s m::!4.Q~f.lad1PJlj the Oregon Utm~175.00 Notiftlilit~~Asrp.~.~~Wtie rules are ~At f~l2:5.00 ' in o~~~~ ,~9~e1fm!bughOARg~?-n~\63.00 009cP."flOJ <m~~cYR\t~opies of the-w!es~~5.00 c~ffi~r~tcevr~er. (Note: the tele~ 50.00 C Tnum, b, e~f r the, or~~ Utility Notification , ',' empora erYlqe~:Qr_ !_~~ _ ' '.. In t II t' entell't.l' R"I'~?f2344). s a a lOn, AIrera IOn e oca IOn / 200 amps or less 201 amps to 400 amps Oyer 401 to 600 amps Over 600 amps or 1000 volts see' "B" above $50.00 $69.00 $100.00 Signature of Supervising Electrician , rlk-, , ~ 'P h 1/\ ....( ~ f D. Branch Circuits U/f.o~ NeW, A1terationor E_,ion rec Panel Address---1.k!{:D (.airier Lv _ , One Circuit ~ $43.00 tf3 (rJO citC,'PkD Phone:J..!it.~~ OWNER INSTALLA nON Owners The installation is being made on property I own which is not intended for sale, lease or rent. Each Additional Circuit or with Ser;i1 ' ..d'\ or Feeder Permit 'T- $ 3.00 12.- ~ vv , , E. MiscellaneoUs (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res . Limited Energy/Comm $50.00 $50.00 $25.00 $45.00 Owners Signature: 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee 5~. OD TOTAL ~ . <f..Z5 ~~. 1/~