HomeMy WebLinkAboutPermit Electrical 2002-7-26
225 FIFTH STREET
SPRINGFIELD OREGON 97477
INSPECTION REQUEST 726-3769
OFFICE 726-3759
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ELE~ ,dCAL PERMIT APPLICATION
Clt~ Job Numhu 02 - oog8'6 ~ 0 (
3 COMPLETE FEE SCHEDULE BELOW
LOCATION OF INSTALLATION
33l..L,. Cke.vD~~ A Ne" Remlcnll.lI,Smgleor
Mult.-F,lmlly per d"ellmg Unit
LEGAL DESCRIPTION ServIce Inlludul
I S<O l C-:> h z. I C>Q_bO a Itcms Cost Sum
-", u.1Uwmg
zonmg a.nd dPro/ecr as SUbrnltt
JO~ESCRIPTIOI'l.. approval oes nOI reqUIre s_~,a'flollmiflfjj ~106 00
j,;.~",,,,,, POv!.e,f .':l,,,,, Lf)vz.. Edel, ,;a[\~1/fflih1500
/ Dat V - sq It or portlOn
Pel mils are non-transfer"ble and e,pIre 7- b -0 Z. hCleot $ 1900
If \\ork ]5 not started wltlull 1801t*~r/zeC1 SIgnature -lame or
of Issuance or If work IS suspended for lar DwellIng
180 dd\ s ServIce or ee er $ 50 00
2 CONTRACTOR INST ALLA TION ONLY B Slrvlee, 01 Flulel S
I Inst"lI,ltlOn, Alter'ltlOn~\O:l.'l
Eleetneal Contractor C /AN'tS Ii< d(~ l. r~'G Reloe,lllOn ~\<,0<i;> f>\\J\~~o~"
~ \ I ~ \eOl. ~eQ,o 'be\ >:J'V
Addless '3333:I1 T 0'1 II wllo iCo 200 "ml~\~i'{<\eO e,=-~e <?J"::fl-.<::J 'Qi H3 00_
20i <!)\fPse!)'ll1'lo i\l1I~ Oty..'<- e (U\#"-'- $ 75 00_
\'~1<J1 ,w~\,,\&\\Wa8~" o'~ ~"O(:l')~$125 00
(\ "'~ uftft "?i!Jlj)S\!R.~~< 1l,~'" e \e\\~\~ $163 00 =
I" ~O~\ f6",<;'J~~0}M\\~ldY~e ~ ~~o t37500
,o"_~\"iI~~h)')e~~'t ~ \J\~\ rt.r:,IJ<b.'~ $ 5000 =
~o~t>-'" .J OU <$''<> "e~\J(\te~o~O'.rg,'l:
C'(\-r;~lO)'.~'ci'b~ec's'!l{,~del ,
ml,t..~f.O!N\l\)t(\MtThn or Reloe,llIon
v ~'O'" (ft(\ v
<.'<\~ ~
200 .Imps or less ~50 00 /
201 amps to 400 amps ,,""~~~6900-
O\cr 401 to 600 :ll~\~~~o.,~~ \'::l ~'-~100 00 =
O~ 600 aJ~~'I?:.';:,~~~*~ ~
~~,\\$j ~~~~ ~~\)~v. ~~\>.~\)()~
D o.~\~~\1,~~~ (}~ \~ ~.
\>'\}1~~'rllr~I\\~~nSlOn Per Pdllel
c,(j 'J..'O'U \)
\Iol~Clfelllt _ ~43 00
CIty c.:,~ uJ..(.( ( Phonc 8!lS' - 3G.<-,0
32":;?-;>?S
SupervIsor LIcense Number ~- ~
E,pnatlOll Ddtc
IV / m ( 104
l . \
"'2.3 77
101 '" lr>1,--
,
Constr ContI NU111bcI
E'\.puatlOl1 Date
SlgJ1.lhll c of SUJlLll l~lllg ElcctllLl.lll
c- If: -L-! 17,- ~// ./
O"lIel' N.Illie_.~ e.!.~. t:'.ev w ll~
Addle" 33.<-'{; d€.V'o\(~
Clt) <:;'f'YI~.\;'~ Phone 7'LC,-3.'tsz...
OWNER INSTALLATION
The lIlstdllatlOn 15 bemg made on
prOperl\ 1 O\\n \\lllch IS not llltelldcd
for sale ledse or rent
Edeh AddlllOnal CIrCUIt or \\Ith Scrvlee
or Feeder PermIt
$ 3 00
E l\hslLll.meou, (Servlce/feedel not mLluded)
-Each mstallatlOn
Pump or IrngatlOn $5000
SlgnJOuthne LIghtmg $50 00
0" 1I11' Slgndtul n Llllllted Ellergy/Res 'j;25 00
~ /~~~Li.4-- LlImtedEncrg\/Comm Q500
t90'(r.Jllic;ii:J ~"R-e&: ~ ~J_jJ,-{J 1\I1Illlllllm Electtle Pelmlt ImplctlOll Fcc" S45 00 + Slllcll.llge'
~~N\i'1:J ,...-' "IV ~
{ -, C;' $ G :a;j~ l\<v 19-r- .\~\.p-4fI.V' (b~ 4 SUBTOHL OF ABOVE s-o
1,00, 9:: lOr.31\JG 7% St.lteSUllb,nge 3'50
6S00 COO.. ro :jtSNoOl 8% AdnllIll,h atl\e Fee '-100
TOTAL
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