HomeMy WebLinkAboutPermit Electrical 2001-3-26
SpAF,ELD ....,..,~.I
DEVELOPMENT SERVICFlY !JS/l\O.iI!(fIMl/lll/las submitted has the following
zOning, and does not require specific land use
approval.
(VfL
'2, - 1.lb~
Zoning
Date
225 FIFTH STREET
SPRINGFIELD, OREGON i9J7riv7i1.eo Signature
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALhATION ..lL
\ I (" lp S '.Lt' J~Y.-
LEGAL DESCRIPTION
JOB DESCRIPTION. ,
ii'~~-, I~_~
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days. C9f- \'11-
I
FAX (
ELECTRICAL PERMIT APPLICATION
City Job Number 0/-0/')"24",9-0/
3. COMPLETE FEE SCHEDULE BELOII
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
.'" ~ .'. Installation, Alterations
Electrical Contractor" J')J-( ~CI..E1C )Tir:.or Relocation:
Address)) ()(oS- I J J. 1!"~1, i:\::; f ~ 200 amps or less
I .. .'. 201 amps to 400 amps
Ci ty(::::.-llCIE: li,~ PhonU:t. "') 7- 1-0 401 amps to 600 amps
, I /]0 . Q 601 amps to 1000 amps
SupervisM Li cense Number.. 'J,s f/J '- ) Over 1000 amps/volts
Reconnect Only
Expiration Date In /, /01
. ,
Constr Contr. Number ,~-=t-h5<7--C:
Expiration Date /L~/' / II I
Signature q~ s~e~ising Electrician
~ /6 '-"f fi ~A-/I .
(j
Ovners Name
Address
City
Phone
01lNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT #:
RECEIVED BY:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00 -:s.5.~
Each Additional
Circuit or vith Service , / .~~
or Feeder Permi t ~ $ 2. 00 _~J.}"'\
not included)
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
3o(,(J()
.?I.1-"1
l. v::;:
Lf"2.. 'f?
40.00
40.00
20.00
36.00