HomeMy WebLinkAboutPermit Electrical 2001-5-21
225 FIFTH STREET
. SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
ELECTRICAL PERMIT APPLICATION
b 'tted has \"'[' fono\' .'
. proiect as su ml d '
The followmg. . I e S\JciCllI1. !<In ,...."
. . a"d does not lequ I
zoning ,.
225 FIFTH STREET approval. L.D vt-
SPRINGFIELD, OREGON 97477'. Zoning ----:;/ 62 ,- 0 ,
INSPECTION REQUEST: 7?Jfe3769. - ~-
OFFICE: 726-3759 '" C1><V\../
AUUloriz.ed Signature - 3.7 COMPLETE FEE SCHEDULE BELOV
1.
LOCATION OF INSTALLATION
/-1 L S- {. AiV2.AQ L
LEGALDES~PTION
/70:3 Z8Z--/
(0301
\\_ JOB DESCRIPTION .
r<)\JS~ ~. ( .<i _ - ~ -rt~. ~Ou.Jtl-
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-t.u)! J...E.I LB,oC)
Address UO t s-<1. ~Q]]j ~ ~ Uy-i.~
City ')r~ \J Phone /4t-77lli
Supervisor License Number lj171<)
Expiration Date. It\ '01 -01
Constr Contr. Number 7n ~tJ LI lL
Expiration Date IO-ot~o,
ci ty Job Number t:::JI- 06S'1 h - 0 I.
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B~ Services ot Feeders
Installation, Alterations
or Relocation:
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
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services.or Feeders
Installation~ Alt~ration or Relocation
srzorhA~pervi~~an
~.ers 'Name ~e-L~.. ..Z;:PrjC6-~.
Address (72 S- G;a~( A-s~ 31-
sf (~(:J
r
City
Phone
OVNER INSTALLATION
.The installation:is being made on
pioperty I own which i~ pot intend~d
for sale, lease or rent:
Owners Signature:.
,.,' .
---------------------------------------
DATE: 0<)"2.( 0 (
RECEIPT #: ....... _ ':::;f.(.)T"
RECEIVED BY: . I , 1<""
200 amps or less l $ 40.00 ~QoO
201 amps to 400 amps $ 55.00
Over 401 to 600 amps '$ 80.00
Over 600 amps or 1000 volts see "B" above
Branch Circuits
. .
New," Al teratiori or Extension Per Panel
One Circuit
Each Additional
Circtii~. or with Service
or Feeder Permit
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
E~Miscellane~u~ (Servic~/feede~ not 'included)
-Each, installation '..
Pump or.irri~ation
Sigri/btitline,Lighting
Limited 'Energy/Res
Limi ted EIlergy /Comm
$ 35~00
$2.00
$ 40. 00 '
$ 40.~' -l
$ 20 .f\oA~ 0 :;:1':1
.VV. I> T.:>
$ 36.om rri.~
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