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~
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{p $___ '" 0 ..
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