HomeMy WebLinkAboutPermit Electrical 1999-10-1
.
alNGFIELD
225 FIFTH STREET
SPRINGFIELD, OREGON 9YJ4fl37
INSPECTION REQUEST: ~~~io~~9signature .
OFFICE: 726-3759
The following project as submitted h~~ the following
. nd does not require specific land use
zOning, a
approval. L- oR
Zoning q' C
\ (, - \ - l
v=
3.
V,LECTRICAL PERMIT APPLICATION
'19 I~ 3~
~ity Job Number
COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION
1150 C,1.A5.-Mm Il"'lOu
I
. A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
It 0 ~ 1.,,(0 3cJ Ocq crt
Items Cas t
Sum
,-
JOB DESCRIPTION
Hp-pl O(\P ('9-0~ ~ d",n(>~p /..0 I'.u... Qe-W
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular'Dwelling
Service or Feeder
$ 85.00
$ 15.00
.$ 40.00
.B.
Services or Feeders
Installation, Alterations
or Relocation:
'.
!
I
,
Electrical contractor~ ~(Q~(,
Address ~6l~ {VL YJ1rJ..r~
Ci ty Cr eJ.J..JC1 ( Pho~e ~q5- 24t-10
Supervisor License Number ~/Lf..S
Expiration Date 10/1/00
Constr Contr. Number 6o(Q?SCfCJ
Expiration Date ~ 1//'8/01
200 amps or less
201 amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Re20nnec t . Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
,
.,
.
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Sig,n.~ure
of Supervis~g
r~'
~ '--'
Electrician
,
200 amp~'oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
O\{ne~~.._me 1..,.0.<'+1".1'" () uC'h n
. '-.)
Address II <So ~~Lu-a...-.....-
u
D.
Branch Circuits
,
,.
New, Alteration or Extension Per Panel
City ~r
OYNER INSTALLATION
Phone
One Circuit }
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00 ~.<JO
$ 2.00
Owners Signature:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
---------------------------------------
5. SUBTOTAL OF ABOVE
7 $% State Surcharge
3% Administrative Fee
TOTAL
35,00
~,<./5
11" ? ' 05
,_~ ~ '.5...D
DATE: 10, \- 4 4
RECEIPT #: {)?h1 Lt Lf
RECEIVED BY: ~'\