HomeMy WebLinkAboutPermit Electrical 2002-5-2
I. LOCt\T10N OF I.MST ALl,A TION
"7 b ~ jd- 'S -r- A. New Residential-Single or
Multi-Family per dwelling unit.
LEGAL DESCRIPTION . ubmitt~iYilllldiRIlll'di!lP.
---1-70.3 3S'-f z.. 0 '-/. ~l6Dbwmg prole~~~~:quire specific land use
zomng, (::IIIU does
approval. () Vf\ .
JOB DESCRIPTION -La.-' 9 --\" \ v 11100 ''1.tt~. "-." .
Iln <={ I zonm ~ .. I
vv(,,_t:'" ,u",'--tl"",,,",. \ ~.~_O'2Eachaddltlnn.<OIl
. . Date . .fl.i.Q1 ft or portion
Permits are non.transrerable and explr~ thorized Signature .....III..VI
if work is not started within 180 days U Each Manufd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
.
225 FIITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
. 'f ~
ELECTRlC"-ERMIT APPLICATION ,:
"
City Job Number 0 7... 00 230 - 0 I
3. COMPLETE FEE SCHEDULE BELOW
I
Items Cost
Sum
$106.00
$ 19.00
$ 50.00
2. CONTRACTOR INST ALLA TION ONLY B. Services or Feeders
(' 1 C r::\n -.-.- Installation. Alterations or
Electrical Contractor Jj\ ) c::-J<;:rtYlu.J..fC, Relocation:
Address 'fl.O. DLX 14~1- .
ci09ri~t:~ Phone 14-I-j23lo
Supervisor License Number ~ 4S
Expiration Date I D \ I \ nl..\-
Constr Contr. Number 2fLjLj
Expiration Date Cj \ I I 01--
Signature of Supervising Electrician
~: 'CE fJ.QQ
Owners Name~Jh.v..,a. / A-t\I tF P~Ic:; D.
/11,11 S/-
726 -1(33J
Address Zo 0 5.
City s//fJ Phone
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
mO:i:l3IH8\7:J
:39N\7H:J
~~'9~G $ G:O:J3i:1 lW\7
GOOG GO A\7W:31\70
~088000-10:#8N\7i:11
200 amps or less $ 63.00
20 I amps to 400 amps $ 75.00
40 I amps to 600 amps (e-"""'< $125(00
...w ;;0--# . -
60 I amnsto,l OOO,amps\o'"' "" orn...",$t63JOO
"',r,....".._ db the ' -
Over I\OOO,amp.sl.voltspte Y ul-~ ;,,,$3J5[0.O\"l
fo,iu'.''''''-' Th er - -
Reconnect..Onlycenter. os r -'J,~Q~~~O!001-
r;,otl~R952_001-001?thrO~~~ 01 the rules bY-
C. Temponi!Y~l'rvl'O::, '1fl!i~erS\ln cop. the telephone
InstallatidR ta\IW.~N!f1JOJER.elooif~~t~tility Notilicatior
"'Imberlor the Oreg '\'\1'-2344).
200 amps or Ir:~nteris 1_R(l(l-.. _ $50.00 _
201 amps to 400 smps $69.00
Over 40 I to 600 amps $100.00
Over 600 amps or 1000 .volts see
"B" above
Branch ~fri'fc~: HA\.L EXPIRE If 'THE WORK
NewJ~~~M.rt~fmli~ ~~RM\1IS NOT
AUTHORIZElfUNu nONED fOil{ '1
One rooMMENCED OR IS AB~ $43.00 _
~NV 180 DAY PERIOD.
Each J\ifditional Circuit or with Service
or Feeder Permit
$3.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighlinq
Limited Energy/Res
Limited Energy/Comm
I A~r,
,I,
1'\;,
5. SUBTOTAL OF ABOVE
7% State Sur~harge
8% Administrative Fee
$50,00
$50.00
_$25..l19
~)
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1Sl7J I
TOTAL