HomeMy WebLinkAboutPermit Electrical 2000-1-14
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DATE:JAN 14 2000
AMT RECD:2 $ 123.20
CHANGE:
CASHIER:032
ELECTRICAL PERMIT APPLICATION
Clty Job Number Q:) -()~ ')...8 - Of
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The followmg project as submItted has the following
zonmg and does not requIre specIfic land use
approval L D fL-
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225 FIFTH STREET Oat?
SPRINGFIELD, OREGOt+\~tJd Signature
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
LOCATION OF INji,TALLA!.ION , /J [) 1(/"
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LEGIt(f?1~~~ <: - O~ -; GO
JOB DESCRIPTION
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Perm1ts are non-transferable and exp1re
1f work 1S not started w1th1n 180 days
of 1ssuance or 1f work 1S suspended for
180 days
3. COMPLETE FEE SCHEDULE BELOV
A. New Res1dent1al-S1ngle or
Mult1-Fam1ly per dwell1ng un1t
Serv1ce Included
Items Cost Sum
1000 sq ft or less $ 85 00
Each add1t1onal 500
sq f t or port lOn
thereof $ 15 00
Each Manuf'd Home or
Modular Dwell1ng
Serv1ce or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Serv1ces or Feeders
Electncal Contractor1:~f:I"'/f(;'2 1 Cw.,ulI ~ Installat1on, Alterat10ns
or Relocat1on.
Address (J,d 05 OX- ;)"Y'9-l1 200 amps or less ~ $ 50.00 !M-OO
~ 201 amps to 400 amps $ 60 00
-,. Clty Phone ~E-d, 1'7::' 401 amps to 600 amps $100 00
'-' 601 amps to 1000 amps $130 00
Supervl~or L1cense Number ;:.{J, ~~7;_\ Over 1000 amps/volts $300 00
Reconnect Only $ 40,00
ExpHatlon Date /6 ~CJ/-oJ
Constr Contr Number ,--.Qfj6~'~ge
Expnat10n Date $-g~/LJy/ -do
Signature of SUperv1s1ng Electr1c1an
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Owners Name _fYl,r,~ ~ 0 1.' --o1'l1);..J
Address ~f_rR' a~
Clty Y6 J/V) Phone 7V4':-S!Vo 11M
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OVNER INSTALLATION
The 1nstallatlon IS be1ng made on
property I own Wh1Ch 1S not Intended
for sale, lease or rent
:::t;
OImeIC2. ~Igna ture:
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DATE '-l:S:. >:1. - N--crt)
RECEIoP,T -#. u...... o...s -If I
RECEI:VED tit;', ~ cf<.-J
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to c.., (.or) m t......1
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C. Temporary SerVIces or Feeders
InstallatIon, AlteratIon or RelocatIon
200 amps 'OT less $ 40,00
201 amps to 400 amps ----- $ 55,00
Over 401 to 600 amps $ 80.00
Over 600 amps or 100u volts see "B" above
D.
Branch C1rcU1ts
New, AlteratIon or ExtenSIon Per Panel
One CIrcUl t
Each Add 1 t lOnal
C1rcUIt or WIth SerVIce
or Feeder PermIt
$ 35 00
2 00 /) DD
-0- $
E.
MIscellaneous (Serv1ce/feeder
-Each InstallatIon
Pump or Irr1gatIon
Slgn/Outl1ne L1ght1ng
L1mlted Energy/Res
LImIted Energy/Comm
not Included)
5
$
$
$
$
1) ).()Q
40 00
40.00
20 00
36 00
-
SUBTOTAL OF ABOVE
7% State Surcharge
3% AdmIn1stratIve Fee
TOTAL
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