HomeMy WebLinkAboutPermit Electrical 1999-10-20
. , bmitted has the following
The following project as su, specific land use
zoning, and does not require
approval, L.-. O.~ '
N Zoning - ~ 0 -C[ q ,
225 FIFTH STREET n ~r/cr. \ O?f ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON lft1!jJiB~ Signature - Ci'Cj I U
INSPECTION REQUESTIU.rPi1d~I?f!Jf)SHALL City Job Number f / 7 52-
OFFICE: 726-3759 Co rllZEDU ExPIRE
-LI MMENCJ::n IfVDER iHIS IF"PHE W8MPLETE FEE SCHEDULE BELOY
1, LOCATION OF l'N~~f<9RISLlr.. PERMrr-, fI:1k "
2-51 tv, ~f...L~fO.- ~ANDONF'li!IS~Residential-Single or
'VU. ~Fo~ulti-Family per dwelling unit.
, LEGAL DESCRIPTION . Service Included:
/11> 1..2- 7 Lf'l, CJ I Jal It ems Cos t Sum
.0. _
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders.
Installation, Alterations,
Electrical ContractorL ~ s aa-h1cj litle, ;or Relo'cation':
Address PD l0DX' It-t-~J...' 200 amps or less I $ 50.00 .s--v
201 amps to 400 am~s $ 60.00
City~r+~/,d' Ph~ne -'1-fL-~7/oltJ 401 amps to 600 amps $100.00
, . '!,}'ENTION'O~ 901 amps to 1000 amps $130.00
Supervisor License Number t~<p.~~rtJlt::l'=':1dO ~gOno~~er';~_Q,Q.'1]<}W}1.~/volts $300.00
'D {'Jotlfecation ~e"'t p e~ b,Re0PQ};lt;thtn On,t~ $ 40.00
Expiration Date I -01,-0 in n!J,RQ~~' ~,..,:~ er:,~~osarvlesa;.~ ~~:~~~.
0000, vou v I OOG'.f if1Kemp.o-ra};"!,,''''Se'r-v~ces or Feeders
')0 II l {', :~. . II mal b' ",-";' '~'f;\,'l:Jul:'~ n
Constr Contr. Number a.. U""1/Vc~/1:..".~.", YO- tamCCfJlesaIIafronv,Oti.lteration or Relocation
. .-:. u ",;; ...~l1ter ('\Jot '. . VI me rUles by
Expiration Date ID-O{-CfC1, nUmberfOrlheOr~C!~:12~d6~~ij%P\\w'fless . $ 40.00
, . Ct:liiens 1_800_,26:r;~clM'p.t~fiQf0ic~0 amps $ 55.00
Supervising' Electrician "(j~fefj~d;L to 600 amps $ 80.00
~ . Over 600 amps or 1000 volts see "B" above
I D. Branch Circuits
,!h,! ro~ ttllZ"f5tJ/V
I
Address ') 21 () IJ (;f 11.. ~ 1114 h ~ 0 J1-
( ,
Phone l{fr;~ 1),1"
. J<~PTI~ "
Permits are non-transferable and expire
if work ,is not started wi thin 180 days
of issuance or if work ii suspehded for
180 days. '
o
City
~
OVNER INSTALLATION
The installation is being made on
property I own which is not .intended
for iale, lease or rent. .
Ovners Signature:
~A~~~~--~-7iJ2dJftf1'~---~----7~--~-----
RECEIPT #:' I, 0' ') ..r'7~-G%
RECEIVED BY: ' c:;{ tJ7
1000 sq.ft. or less
Each aqditional'500
sq. ft or portion
thereof,
Each Manuf'd Home or
Modular Dwelling
,S,ervice or Feeder
" (. -,
$ 85.00
$ 15.00
,$ 40.00
,.
New, Alteratibn or Extension Per Panel
Miscellan~ous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energ~/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Se~vice
,or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL' ,
$ 35.00
/
$
2--
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
u_' , $ 36.00
s;- W
5, (" J.f
I.S~
. ') 7, 2-1J