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HomeMy WebLinkAboutPermit Electrical 2000-1-14 '/ 4 DATE:JAN 14 2000 AMT RECD:2 $ 123.20 CHANGE: CASHIER:032 ELECTRICAL PERMIT APPLICATION Clty Job Number Q:) -()~ ')...8 - Of Aj) The followmg project as submItted has the following zonmg and does not requIre specIfic land use approval L D fL- ZOOlnr' t-/'f-- C'-O ~ 225 FIFTH STREET Oat? SPRINGFIELD, OREGOt+\~tJd Signature INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INji,TALLA!.ION , /J [) 1(/" ~/S-rS (!RAvI~ Dc- -r LEGIt(f?1~~~ <: - O~ -; GO JOB DESCRIPTION .s=." ....N'~ (7'1~ 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 <~,,~dA- Owners Name _fYl,r,~ ~ 0 1.' --o1'l1);..J Address ~f_rR' a~ Clty Y6 J/V) Phone 7V4':-S!Vo 11M bJ-( -GG z.r- "'-"'" OVNER INSTALLATION The 1nstallatlon IS be1ng made on property I own Wh1Ch 1S not Intended for sale, lease or rent :::t; OImeIC2. ~Igna ture: <t:-::co:: "::1-fT1 ,,1rr_lS) - .,. ,--. -----C)-~-C1--0~------------------------ DATE '-l:S:. >:1. - N--crt) RECEIoP,T -#. u...... o...s -If I RECEI:VED tit;', ~ cf<.-J ~-lW'1~..J ~ w (..I1~ ..roCl to c.., (.or) m t......1 ....,J;,t..,;lO ." t/i 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 / 1.1. .J..()