Loading...
HomeMy WebLinkAboutPermit Electrical 2002-5-30 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 ,-Q.0~ ELEM.lli PERMIT APPLICATION P')} --003 - '-~O City Job Number t/c. S ~ ~ 3. COMPLETE FEE SCHEDULE BELOW 1. LOCATION OF INSTALLATION ',5'b (:., ~M.p_ O~r >/-;7~' New Rcsidential-Single or I P-t t.J Multi-Family per dwelling unit. LEGAL DESCRIPTION Servifj,e..Included: I ~ 0 Z. 35"33 0 3:>q!? rniAct as submitted has the TOIIOsWI1~ , I nt:: lul1v.'rt.", r. not require specifiC land u ,2, , f zOning, and does JOB DE~GR9?Tij>' aripro\7al / 1 ;DeL 1000 sQ.fLor less Cdn1 ~-ltn-. f)5;..IL tth .~g ~/ rJ. 0 r 0 ~Each addit~nal 500 S J '. I :>q. ft or portIOn Permits are non-transferable r&\texpire e d"'\J-.I. ~11.eI'Zgf if work is not started within 180'l:iit~eo SIgnatur - Each Manuf'd Home or of issuance or if work is suspended for Modular Dwelling 180 days. Service or Feeder Items Cost Sm:n ;j Ge ! $106.0lf1ld~;- tr tit d& ) $19.0811 (q(~ $ 50.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders +- ~/4' Installation, Alterations or Electrical'Contractor 5 I HSl.e f..r'z& I(;. ,tU:::/tXf'l"c- Relocation: Cfc. I 'f/:?' {. v'JJ,~ I~ Address O' 0 ~ rP.:?"'C@J<iY< ",,' 200 amps or less I#. ' " ^ 201 amps to 400 amps citfUJfiel~ Phone 6'V f ...., 7 2. ~ I Y.fk 401 amps to 600 amps 601 amps to 1000 amps Supervisor License Number tft{.J "i"S . Over 1 000 amps/volts Reconnect Only Expiration Date /.1 /f N €f . . , "i'r J? <.P&/J:- C. Tcm Constr Contr. Nuni C. C IJ fb t> U J ()~, () l '~.;-;;, Expiration Date_I /t 1&1<3 $ 63.00 $ 75.00 .1,f1,ii,<-$125.00 It, ',," '::$163.00 $375.00 $ 50.00 Signature of Su lcrvising Electrician " //// -/.?~ ",.~--_.. - y Owncrs Name t1~ .1J~;6~ o amps \>"to 600 amps OVe!r 600 amps or 1000 volts see "B" above $50.00 $69.00 $100.00 Address (; 6-:LJ C~t:~ Cit{)/~ p~ IP-r Or'''' . ~:r~ -'" :. ;.~ D. Branch Circuits .'.,:'j'~<'(~J).\"~.. New A1tcrati'!lli,or,e......-.wn~Grl~.Pet'Pane1 , ..:,..> ",<)\.'::>:~,. ?ne ein,nit .'.}. .\':\.~~\;:~,_~~.::. . , " ..~ . . .:' . ." 'Ea~h Additio~Cl(eir211i.rci~ ;\vith Service or F eedei; Peil\lit. . $43.00 $ 3.00 OWNER INSTALLATION The installation is being made on property lawn which is not intended for sa Ie, lease or rent. Owners Signature: E. Miscellaneotls(Setvice/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting Limited EnergyIRes Limited Energy/Comm $50.00 $50.00 $25.00 $45.00 Minimum Electric Permit Inspcction Fee is $45.00 + Surchargcs TOTAL ~~(;,.)......; IZS .- ,) .. ~ ~~ J e~ ~ lJ/J /I /o/1Iti( 4. SUBTOTAL OF ABOVE 7% State Surcharge 8 % Administrativc Fee