HomeMy WebLinkAboutPermit Electrical 2000-8-16
s. ~GFIELD
~
DATE:AUG 16 2000
AMT RECD:2 $ 61.60
CHANGE:
CASHIER: 059
ELECTRICAL PERMIT APPLICATION
"
. CHy Job Number 00- 0 1(')L( 6-0 (
The followIng project as Submitted has the followmg
zonIng and does not reqUIre specIfIc land use
approval
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SPRINGFIELD, OREGON 9]1471 'l? - / f..,. - trD
INSPECTION REQUEST: ,726-3J~9 ~ \
OFFICE: 726-3759 AUII'Oflze S,gnalure ~
225 FIFTH STREET
Zonmg
3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION ~9F INSTALfiON
IfI/!3 (/'e1,.nr t;/K/'
LEGAL DESCRIPTION
I +D:':> :2..6 ;). -ot, 0 <;LJ.L 61
A.
New Res1dent1al-S1ngle or
Mult1-Fam1ly per dwell1ng un1t.
Serv1ce Included:
JQij DESCRIPTION .I . 1000 sq. ft. or less
A'?-,.,)fp-A &l1f,-/,,:, .A'f6..rr->....?,CP--- Each add1tlonal 500
V' / / sq. ft or portlon
Perm1ts are non-transferable and exp1re thereof
1f work 1S not started w1th1n 180 days Each Manuf'd Home or
of 1ssuance or 1f work 1S suspended~srrICE: Modular Dwell1ng
180 days. THIS PERMIT S~~CC'E~~lholIFFM.Pt'lbRV
2. CONTRACTOR INSTALLATION ONLY AUTHOP.B'.EDSer.v.fce~I~'tEF,M\1ilfr~OI
COMMENCEC:fJ\~ lJlA:),altJ;.o_n'IErb~'t~n t 10ns
Electncal Contractor ADT Secur1ty ,Or Relocatlon:
'"'' 180DAYt-'I::RIUU
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
SuperV1sor L1cense Number 853;/11> Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
Exp1ratlOn Date 10/02 Io\f1EI\l!IU'- u'c:Ju' ,CO" ,,,,,~,,G_ ,~'
26209CLE fOllOW rUlesartoPt'i1rli\Ycl~afYe!jgp,w~Js or Feeders
Constr Contr. Number l\lotlflcatlonCentelI1b.<\.!iF.L%tt-'i'aW"s~ lj)gratlon or Relocatlon
'0 OAHi102-o01-0010 through OAI1 \:I52-lUl
Expiratlon Date 10/01/00 llOQO Voumayob1OOOCra\lljjsl!6thqlH!~S\)) $ 40.00
calling the centSl~alIilpWe1!ijlP$nEmps $ 55.00
Slgnature of Supervising ElectrichOO1berfortheOf8!JOl1l!Jtlt1tyffl:ltd@@.tlamps $ 80.00
/". _ _~ Cpr*'JfI~ O~-'6'UO:;>amp's 01- 1000 volts see "B" above
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(;"ne:s Name_f7g.~ .4.up;c f:..r:r..f:;/! (tf D. Branch CUcu1ts
Address
1501 Pearl St
C1 ty Eugene, OR
Phone541-342-1111
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
Addres:;
New, Alterat10n or Extens10n Per Panel
$ 35.00
CIty Phone
One CUCU1t
Each Add1 tlonal
C1rcu1t or w1th Serv1ce
or Feeder Perm1t
OVNER INSTALLATION
$ 2.00
not 1ncluded)
M1scellaneous (Serv1ce/feeder
-Each 1nstallat1on
Pump or 1rr1gation
Slgn/Outl1ne L1ght1ng
L1m1ted Energy/Res
L1mited Energy/Comm
The 1nstallat1on 1S be1ng made on
property I own wh1ch lS not Intended
for sale, lease or rent.
E.
Owners Slgnature:
DATE~------;/~;;~---------------------
RECEIPT #: . Q.q~ ,
RECEIVED BY: {,J~
5. ~BTOTAL OF ABOVE
State Surcharge
% Adm1n1strat1ve Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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