HomeMy WebLinkAboutPermit Electrical 1999-2-8
The ,ollowlng project es submitted has the following
zClnint.l uno does not require specific land use
a~"rQVal C c...-
97477 Zoning
l'>21li 07"0
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
.;l.-'(. "'> 'i
~
i-i;;ttlorrzed Signature
1. LOCATION OF INSTALLATION
I(pSo S.tC\. S-IY.u...t-
ELECTRICAL PERMIT APPLICATION
r;. ty Job Number
qq 0 ! (p 7
~vnrLL.E FEE SCHEDULE BELOY
.o.
A. New Residential-Single or
Multi-Family per d~elling unit.
Service Included:
1000 sq.ft_ p~ less S 85.00
Each add N{6'r\'<\.:j!l..s.€i@reYVII'dw requires you to
sq. f t t8poji'or\ei3cMlopted by the Oregon Utility
therecPfotification Center. Those rU$slJfreOOlt forth
Each Mdfl,QA1ij9Fie1lil910lEO' u mrough OAR 952.001.
Modu1a':jO@"<h?l!il1l~y obtain copies of the rules by
Service QJlJ!IIiEl=~nter. (Note: tl$3 falie~fune
numberforthe Oregon Utility Notification
B. Services or F€edinrSs 1-800-332-2344).
Installation, Alterations
Electrl'C (rJ(,:r Relocai~OPl'CE::
200 amps TorSles-s,:::- SHill 'I c:vnlP.$., 5_0.9.9 .50,-
201 amps P,S~'h40.o...,a"1p,~ .. -... s: '60}OOWUHK
401 amps s,o 600 -anipslJUI:H TH1S$'f.9P,tI9Qs t'~~
601 ampsCto 1000 amp,s, 0 ^,,, ;>.)),9. Q.O ,~,
Over 1000~'amps/vol ts ,'. .-"N[S'300'100)R
Reconnec~ Only. S 40.00
LEGAL DESCRIPTION
II n '3 ~ (h -:5 I 6 &v u [,
~ DES~PT~~N_
Permits are .non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor~p~
Address\qS Mach~oY)
Ci ty E: U~ Phone
Expiration
4~S- CAz 2-
L- '9 "1()-:s,
Date Ib- /'~I
Supervisor License Number
Constr Contr. Number 47.,<1 I 0
Expiration Date 12-/O-q~
Signature of Supervising Electrician
r!LuL .--QA../f~A-
{J
Owners Name lbS CIv.....'v~
Address I ("C1 0 A Sf-,r 4....1
City ~1J.). Phone 7l.ff". 1o~1I
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or ren t.
Owners Signature:
DATE: ~ - II -"l '1
RECEIPT W: "
RECEIVED BY: 9'10
"?,;;l.'61 c.j
Items Cost
Sum
c.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps. 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
S 40.00
S 55.00
S 80.00
volts see IIB"
above
,.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
S 2.00
no t included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
s
s
S
S
~00. ---
. ~.<,--;;r:)
i ,.s ti
~Sd. ..-
40.00
40.00
20.00
36.00