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HomeMy WebLinkAboutPermit Electrical 2001-6-26 Date 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 ~~~7~zed Signature 726-3769 .1. LOCATION OF.INSTALLATION U?bo /-/~;u k Iln J,~f2-J.. . A. LEGAL DESCRIPTION I 70 "::) 2-L{ 0-0 0 0 10 ( . JOBDESCRIPTtO~, . r : II 5erz.-V1ce- / c., ~I 1 ~,. f..-Jt::! / Permits ~renon-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. Elec trical Con trac torUl)Jj) \Jdlle.Lj r;;!eL. Address /! la!) ()CP()JI1 s'f: : Ci ty kU9 jP n pO Phone -.10 g 3 -g3l:~ Supervisor License Number ~/J~Jr Expiration Date //)-07 Constr Contr. Number ~~tf/() Expiration Date I{)-{)/ . . Sign.atu..reJP~ Supervising Electrician ~;tcr::;;. .~. -_.. Owners Name T~c( ~oe~ Address z~bo H-AvdG./ -gr; dqt-- YLd , City ~p~ Phone OVNER INSTALLATION The. installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: . ~A~~~-------C;~~~7-------~=:------- RECEIPT #: ~b I RECEIVED BY: . ~ (J ? V ELECTRICAL PERHITAPPLICATION City J~b Number O( -oObJ3 ~O\ 3. COMPLETE FEE SCHEDULE. BELOY New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 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 $ 15.00 .$ 40.00 Services or Feeders. Installation, Alterations 'or Relocation: 200 amps or less I $ 50.00 50 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 . 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $.40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"oT less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 $ 55.00 . $ 80.00 volts see "B" above D. . Branch Circuits ,. New, Alteration or Extension Per Panel . One Circuit $ 35.00 Each Addi tional: Gircuit or with Service or Feeder-Permit 1 $ 2.00 7 E.Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00. $ 36.0~ -' -H::::l;:::O 5l-;o ~ ~ .n rTl (.1). LJ.. '** r-' r-1 C:.-t ..:r D .. c::o I~I' t~? f--L C:;:~l6 - JT1 ::c 0-. '0 ;:::OD(J1 0 .. :z: -.-J ~".:l (J1 (',,:) Ci1 . 0 ',0 cr-. rfl'...,) 0 0..... 1--'- .. 0 I--'--.-J