HomeMy WebLinkAboutPermit Electrical 2002-10-15
225 FIFTH STREET
SPRINGFIELD. OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
.
ELEcaAL PERMIT APPLICATION
City Job Number EL~ ZOO z...- 06) I g
3. COMPLETE FEE SCHEDULE BELOW
1. LO~ATION OFAIN.5.TALLATION
J '-Ie:; IIJ I~ ~ t .
A. New Residential-Single or
Multi-Family per dwelling unit
LEGAL DESCRlPTION Service Included:
/70 ~ 353 Z Tlo.~~;~:%;or' .< submitted has the following
zonmg, and does not require specific land use
JOB J;lESCRlP1!ON appr~v,1 C,.e... 1000 sq.ft. or less
1 Y1 S-f7:( I ( c::e.1'))/'I1 ~oning :'::o:I1.adllitional 500
Date .J, 1tJ/ 15 - 0'2- sg. ft or oomon
Permits are non-transfernble.1md eXllire f(vV thereof
if work is not started ~~l\t61~<fs~ngn~ture .ccu.;ll !vli:wuld Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
Items Cost Sum
-. v
$106.00
$ 19.00
$ 50.00
2. CONTRACfOR INSTALLATION ONLY
Electrical Contractor . ~ r+vo. I
Addres(l tf~ GandfJt ,,-fUI'1' J;;,/a.nd tV-.-.
City ~L{QJ' fl'1..L Phone LflD ir S(pr g
(J-
Supervisor License Nwnber I /jl{q - R rr
Expiration Date I 0 ( I /0 Z.
Constr Contr. Number (oC; I <-14
I/) ( 'l.5?'J () '-I
B. Services or Feeders
Installation, Alterations or
Relocation:
Address:))O jJC;X
70ci
200 amps or less $ 63.00
201 amps to 400 am~~S\le\U~le~"t\U$ 75,00 =
401 am~~~~~paU\lO\ ~'\\~ $125.00_
601~~ ,\\WO~'blUa:>aU\ ~t))3.00
,~~~~ ~~l ~o"''llUlt\~0I~6.00=
UO~~ S dO~U\'ll~ o-\.Oo-~~.~aro.oo_
a~?\I'~aU\\O ri{\OlU\O\.~a~ao\) niN\O\\O\
C. 'Ii"",.",".' Of~oO'll'De~ a~'"
I~ft as ~e1liIRiCU~ l~'~O\l.~
q\lO\ \! uofla10 fl''ll\ UOflEl :
t:al,\o.~.~l ~ $50.00 _
291l~s to 400 amps _ $69.00 _
Over 401 to 600 amps $100.00
Over 600 amps or 1000 volts see
. "liB" above
, ~'\j~~
L'" D. Branch Circuits . """,,)i~~ '8a~'\j'\
f.C. New Alteration o~?~~ ,c#.l
~\.\. ~ ~~ \>~ ~\) ~~
, f\,,\\C~ne.r;:tr~ ~~~ ,'(/ .~'\j'\j~ _ $43.00 _
~v ~\l>~\'- ~~v ~'Ol""
,~\~ ~~t.~~T~:'t or with Service,
~~'\ ~~'\I\)I"., '$3.00
Sl~~.~~ '\j~ ' - -
E. ~eous (Service/feeder not included)
-Each installation
Pump or irrigation
SignfOutIine Lighting
Limited EnergyfRes
Limited EnergylComm
$50.00
$50.00
$25.00
-L $45.00 '-IS 00
Expiration Date
Signature of Supervising Electrician
2~1:J2~/ '
ers Name:..s1-"I~ ?Att[' lJio'Y.
City C:V f- Phone
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale. lease or rent
Owners Signature:
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
} LL-. og
5. SUBTOTAL OF ABOVE 7 d
7% State Surcharge
8% Administrative Fee
TOTAL