HomeMy WebLinkAboutPermit Electrical 2002-2-28
22StLt'u-ISTREET Tg~~' . t b 'ttdh th 111 FLEC1._.jALPEF1v1ITAPPLICATION
~ ~I oWing proJec as su ml e as e 0 owmg .
SPRINGFIELD,OREGONz rl Ig, and does not require specific land use, 0 (
INSPECTION REQUEST:a~~6Wal69 I '" ' City Job Number (')7 - ()o Z:$b ~
OFFICE: 726-3759 Zoning 0-...'1"'\. I
. .D~ tf>. 1" A'6 "tl1....3. C01v1PLETE FEE SCHEDULE BELOW
1. LOCATION OF INSTAL'E.h.llU1\l J \
. '3CoOD Com mp.- y#'(Q.t~'~7}3d Signature ~\. l':ew R@5id6~-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
17C>.3,~ II L
06~O
Items Cost
Sum
JOB DESCRlPTION
1 Y1stall St:cu r;-h..J
I
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$106.00
Permits are non-tranSferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
$ 19.00
$ 50.00
2. CONTRACTOR INSTALLATION ONLY
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
,,0
R;Yer:,J990 amps/volts
c~ReteImect0nly
,0~',"'>J .~\. ~ _~..- ;.
.. ..~..' t...i" .r:fP ;..j ~v j
t," f'><:5; .0. - <~ _';'
p!<i']':eU1pOT<1lYs)SeJNlCe~ or Feeders
..~..~. u t'; v .-:>.... ~~}> ,-"..(' .
.co,>' ,^~n"t.illatron,>AlteratlOn or RelocatIon
",V ~. ,;:.;:- (" .~_ ." '....'
r!.. ~\ (~ 't;::. '-" . v..:. ov... ~~
I ,/0 /:>'(')"'1 9;)0 ~ 0' ,i,,:i :~, .
Expiration Date '. 04- ".".:/) '!..fJJ /....~o ~o~ :$'Q&~:p.~)~r !ess $50.00
6""' ?:J)~r$-' ~~ \jO\!t,g1~~2~jt~'li00 amps $69.00
Signature of Supervising Electrician ~~',.f?:J flj ,.~~ ~I::J'" ,;:$' ,~-fOvef49 ]lto 600 amps $100.00
/J.- ~Iu (J,I ~'J ~lT ~ (, .,J
t:.,'v~;!~ ~ ~~ is> ~0\.' d~,et6,()0 amps or 1000 volts see
/L? 'Y'" .'~ ~o n; ~ 0'-": d'''"B!'~above ~
0A ~ "..~~~~~,(;~<60';;~rp~;,ib..~';<". . ~O~ C'
/. ~~,,6, ,p, ,l;\jlmch CUClUts k fp~
Owners Name:i2ft( Vet2:hLres;' ~ ~0' ell New Alteration or E;tenSio1J~Y~~O~
. ^~~ j ~~~
Address 3fom (1mfr7P-rClaJ' One Circuit // <# ~C:Jq, A~~ $43.00
~ ~~.p-
City ~rl ;e Phone 72/0-//CJ5 EachAd~~nal~<<:;~service
o R ALLATION or Feec;l~~~.::s ~C:J Q' $ 3.00
0' ~ &/jS:P ~O
The installation is being made on E. Misceld6tu..~~Se.};.~~t included)
property I own which is not intended -Eac1\.~ ~ ~~
for sale, lease or rent. Pump Ol~ li.U-~OT$Pf\::)
Sign/OutliQ ~ting
Limited Ener~lRes
Limited Energy/Comm
Electrical Contractor 's:'n i 'rrJ) I Set ..LLnT ~
Address...J1..g ~JLd{b~fUXf- IS. ~
City~g~J(l..P_ Phone 4<01- 5(olg
Supervisor License Number ~ (( ET
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Expiration Date
10- )- 02
Constr Contr. Number-1n5/.1:9
Owners Signature:
$50.00
$50.00
$25.00
$45.004CJO'D
t90:~3IHStjJ
=39N\1H8
gLUTS $ Z:a83~ lWU
7/\[\7 87 cr. I. 31WI1
GUt}G G u.J.:1: vu
9LT8000-10:~SN~~1
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
460V
3/5
~too
TOTAL
S..L7~
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