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HomeMy WebLinkAboutPermit Electrical 2000-12-18 SF .)FIELD 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 PERMIT APPLICATION Ille fOf/owm ~rj(jmg and 9 prOject as SUb "dpproval does not reqU,;rutteol\-tt , , e sPec", ! 225 FIFTH STREET Zonm r- L "ELECTRICAL SPRINGFIELD, OREGON 97477 l1are ,1- /C-.- INSPECTION REQUEST: 726-3769 -/g -0-,) ~lty_Job Number 0 0 - 01776" 0' "Llthor - OFFICE: 726-3759 /Zed Slgnatu'e 1. LOCATION OF INSTALLATION '11;,;. I hA1fLuA L( LEGAL DESCRIPTION 176;'/5'33. O/Jc"::::' JOB DESCRIPTION ~ () 42A_JM~jA/) D{) IT?. Permlts are non-transferable and explre lf work lS not started wlthln 180 days of lssuance or lf work lS suspended for 180 days 2. CONTRACTOR INSTALLATION ONLY Electncal Contractor ,c;n;JJ.--!A J(~ Address Pi) AuX' 11.o;} C, Clty~)/VOV ~ PhoneJOl {P~f"1151 Supervlsor Llcense Number ~~-5 Explratlon Date Jh-/~()I . ~ Constr Contr. Number I LfS'1 III Expuatlon Date R-)tj/D"d- Signature of Supervislng Electrlclan 1fu..U r. ID Owners Name -A-f?c.= Address L{ ~+,=,a..lJQ'~~ l>Q CltyL,o.PAI"",,o. cA Phone 7N-b7C)-'5SCJO OWNER INSTALLATION The lnstallatlon lS belng made on property I own whlch lS not lntended for sale, lease or rent. Owners Slgnature: DATE: t\n\;r...J...tl *: RECEIVED BY: 17{6'0= LjOJ'..(;, 11/( COMPLETE-FEE SCHEDULE BELOV A. New Resldentlal-Slngle or Multl-Famlly per dwelllng unlt, SerVlce Included, It ems Cost Sum 1000 sq,ft, or less $ 85.00 Each addltlonal 500 sq. ft or portlon thereof $ 15,00 Each Manuf'd Home or Modular Dwelhng Servlce or Feeder $ 40,00 B. Servlces or Feeders Installatlon, Alteratlons or Relocatlon' 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 Over 1000 amps/volts $300.00 Reconnect Only $ 40 00 C. Temporary Servlces or Feeders Installatlon, Alteratlon or Relocatlon 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55,00 $ 80.00 see liB" above D. Branch Clrcults New, Alteratlon or Extenslon Per Panel One Clrcult J Each Addltlonal Clrcult or wlth Servlce or Feeder Permlt /~ $ 35 00 ~'""- $ 2 00 Jt- E. Mlscellaneous (Servlce/feeder -Each lnstallatlon Pump or lrrlgatlon Slgn/Outllne Llghtlng Llmlted Energy/Res Llmlted Energy/Comm not lncluded) 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Admlnlstratlve Fee TOTAL $ 40.00 $ 40.~ --l $ 20, oU' 35 D $ 36.0~m~ c-o.. {p $___ '" 0 .. .~ mQ t""IlJl-L "iEr4L.>->-6 __ c:1~$, co 8 C~~b rrl 0J 0 tJ1 c-r-e-e:> 0--