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HomeMy WebLinkAboutPermit Electrical 2001-3-5 '7", . :..J ,:..' 1 At'ff2~ltffjftfSii.!R TSO SPRlNGF'tEt.'6: bE; (5.;t.1..JMr 1 ~()~7 FAX (541~ - - B~ J ELECTRICAL PERMIT APPLICATION DEVELOPMENT SERVIC~~l?&fo~/Jl~o/1fbftrt as submitted has the following . zoning, and does not require specific land use approval, Zoning 225 FIFTH STREET n SPRINGFIELD, OREGON -.J'}';.", INSPECTION REQUEST: AuJrUiZ€Wf;9nalure OFFICE: 726-3759 mIL B -0-0 r ~ 'City Job Number /J/--/JO/)t? -01 3. COMPLETE FEE SCHEDULE BELOV 1. LOCATION OF INSTALLATION . L/ g 3 (ArS t.4l--oG New Residential-Single or Multi-Family per dwelling unit. Service Included: A. LEGAL DESCRIPTION / 702- ~ ~ 3? O.lb5"/51J Items Cost Sum JOB DESCRIPTION ;..n;::'kr PI/)f--1 P 01 ~c:-v;., 1000 sq. ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 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 B. $ 15.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: Electrical Contractor L-; -re ~~rJ?-I.c:., \.i}Address r.(), 60,><- (/1 3CJ 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Phone btk - fCjq t:, Supervisor License Number ~ C; S '3 5 {O /1 /UIJ/ . ( Constr Contr. Number C;?r::;..ljX-- Expiration Date' Z; / ( !VOv / Signature of Supervising Electrician fl '!~. ' cf "'. ! 4:frVL/, Owners Name h ~ W / VZ-rt-I- Ci ty r::3L/b./~ Expiration Date Temporary Services or Feeders Installation, Alteration or Relocation C. 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above Branch Circuits D. New, Alteration or Extension Per Panel $ 35. 00 ''PS c!>C/ One Circui t .? Each Additional Circuit or with Service or Feeder Permit $ 2.00 Address if tf '3 Ci ty ~ y::-,t? , ~ f ~~G Phone 1 1.& .~Ll L&5 OlmER INSTALLATION The installation is being made on property lawn which is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 Owners Signature: ..- (/0 1':> ,~ 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL ~AT;~-----3-~~~2)?------------------ . RECEIPT #: /1 "'frstJ S- RECEIVED BY: ~~ ~~ <;,.~