HomeMy WebLinkAboutPermit Electrical 1999-4-13
SPRIIIIoIGFIELD
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The following project as submitted has the following
zonIng and does not reqUIre specific land use
approval
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Dale 4 -,,,-,.,
9;~~~~'ftl'~ S'gnaturc ~
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
S 7 '> 'f I'.-~ 01/..4 k.fJO IJIl.
LEGAL DESCRIPTION
dn2t'J&/2. (JO(,OO
JOB DESCRIPTIO~ /
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PermIts are non-transferable and expIre
If work IS not started wIthIn 180 days
of Issuance or If work IS suspended for
180 days.
EXpHatlon Date 10-DI-4'1
Slttf ~ectrlclan
4ers Name 5~ ;:r ~
Address J 7 ? r t~kP I~
Cl ty c.., fJ hi Phone 7'f '/- if / S(
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OVNER INSTALLATION
The InstallatIon IS beIng made on
property I own WhICh IS not Intended
for sale, lease or rent
Owners SIgnature:
-----#-- - --------------------------
DATE: I ff
RECEIPT: () 5J'fr'1 . , .
RECEIVED BY: ~ W ~
ELECTRICAL PERMIT APPLICATION
;;~ty Job Number
3. COMPLETE FEE SCHEDULE BELOY
99(/ L/f1
A. New ResIdentIal-SIngle or
MultI-FamIly per dwellIng unIt
SerVIce Included.
Items Cost
200 amps 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Clrcul ts
1000 sq ft or less
Each addItIonal 500
sq ft or portIon
t;l)ereof
..: % ~Eh. Manuf'd Home or
Oa':>O ~~ 'ito8'-9.J.ar DwellIng
\90 '91l <S>Ji~l(Se or Feeder
.,~ ~1; ~ ~~o., (9<5'';''0
2. CONTRACTOR INSTALLATION ONLY ~6~'" ::>1 ,~"6'r Feeders
"J ~""/-~(9%J1~ ~c'&m, Alteratlons
Electncal Contractor lYUS GLeUVIC) 1V\~ 0....'" 'MrJ06~X~a'6?~
P ~~~~Oo~~
Address 0 WI( Ilt~L- (9-:..<5' ~~:~%<l'~...f::l(9h&S $ 50.00
?, ~f~1ilP.~.A~~if.:...mps $ 60 00
CIty C.xJd Phone/Li/-l.-7-2,lo ~cj.,fh&.i"~-ij'~~....a.'"iPS $100.00
~' 'WJ ~1(l7~"&2(')c.ft.mps $130.00
Supervl~or LIcense Number \lD~\S O~ ~~m~~fVs) $300.00
ExpHatlon Date lD-OI-DI ReC(}~ %eof:'~!'q,-,O~; $ 40 00
C. Temporar)t~~-rtices or Feeders
Constr Contr Number 7J0IYC/ InstallatIon, AlteratIon or RelocatIon
Sum
$ 85.00
$ 15 00
$ 40.00
$ 40.00
$ 55.00
$ 80 00
see fiB" above
New, AlteratIon or ExtenSIon Per Panel
One CIrCUIt
Each Add, tlonal
CIrCUIt or WIth SerVIce
or Feeder PermIt
E.
MIscellaneous (SerVIce/feeder
-Each InstallatIon
Pump or IrrIgatIon
SIgn/OutlIne LIghtIng
LImIted Energy/Res
LImIted Energy/Comm
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% AdmInIstratIve Fee
TOTAL
$ 35.00
$ 2 00
not Included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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