HomeMy WebLinkAboutPermit Electrical 2001-11-9
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225 FIFTH STREET ~~\'\as \\,\e ~ use ELEC~ PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 . 0 . ,\Ie oiliC laO
INSPECTION REQUEST: Z6~~~ 00 lei'l'i". C' Number CJ (~O I Z. 0 lj- 0 r
OFFICE: 726.3759 ,,\,\,\eIO ao<l <loe \ ,\,v...
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~ID>\l10,al:"'on\Q9 3. TE FEE SCHEDULE BELOW
1. LOCATION OF IJo.j,STALLAl'lON c:..:---______
_ h 7 0 ~ It-/;< 0-. (r ~ew Residential-Single or
oa'o . e<l S\90alU'0 Multi-Family per dwelling unit
LEGAL DESCRIPTION i'u\\'\o"~ Service Included:
/70 Z ]Lft( o-::,2VO
JOB DESCRIPTION
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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 51JiuE. /#l1X:.k,
Address $;?g oS '-I/,fi .s-i
citySfl'i..fir)jt Phone ;;);),/-~b~r
. -
Supervisor License Number 3S 11 S
Expiration Date )0 - I - 2003
Constr Contr. Number It/H I g
Expiration Date
4 - 30 - 2003
Signature of Supervising Electrician
~_,( ~~ '113-"'184
OwnersName~ ~\ .
AddreSs~\O Gt\~
City <;.N}r{, Phone 5fl\ 1CD0
O~ d.StALLATION '
The.installation is being made on '
property I own which is not intended
for sale, lease or rent.
Owners Signature:
190:;:J3IHtibJ
: 38NtJH::J
Og'Ltl $ 6:0::J3;:J lWtJ
1006 La ilON:31tJO
606LOOO-I0:#8NtJ;:Jl
1000 sq.ft.' or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Insta1Iation, Alterations or
Relocation;
200 amps or less
201 amps to 400 amps
40 I amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
"-;
C. T...mt'u...c:u.J Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
liB" above
---.L $50.00 S 0
$69.00
$100.00
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit $43.00
Each Additional Circuit or with Service
or Feeder Permit $ 3.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Corom
$50.00
$50.00
$25.00
$45.00
Minimum Electric Permit Inspectiou Fee is $45.00 + Surcharges
5. SUBTOTAL OF ABOVE &:;c:7
7% State Surcharge
8% Administrative Fee
TOTAL
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