HomeMy WebLinkAboutPermit Electrical 1999-7-13
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SaGFIELD
ThE tol/owing project as sub '
l"'ll/19 and does not reqUi~Jtted h.as the fol/owing
'c.i-'j.Jloval specifiC lana use
Zoning.
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
9 7 4 7'7'-"ZI;;O Signature
726-3769
,
ELECTRICAL PERMIT APPLICATION
l,l ty Job Number crq n 71 0
3, COMPLETE FEE SCHEDULE BELOY
1, LOCATION OF INSTALLATION
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--i!tfl~X!1flI8N /5f1) OJ
A, New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
Sq.~~ r portion' .
t~ C:fO~ '$ 15.00
E~ ~,4J~~~8;QOIb'~o' '
Service~l~~& S/~_ ~I>'~ 40.00
, ~Q'h &O~ v~Q. :9/-1
,B, Services or Fee'cR!~ 'l'JO.!l '~~~~ 1\11>'
Installation, Alter~~p~b'OH/~OQ
Electrical Contractork.~ iC.J/Jr;-ll/G 1Ca..ra//.~. or Relocation: vVb'..::,>> _"'4.I/P'
: , .~ '7o'S/J
Address O.o.I>O'? J.Yf13 200 amps or less ~I.JO't"-so.OO,
a 201 amps to 400 amps ~ 60.00
City 7A.p...P/I~ PhoneJai't''/6/J? 401 amps to. 600 amps $100.00
LI 601 amps to 1000 amps $130.00
Supervisor License Number 3 '1975 Over 1009 ~.mp's/yolts ,.. .__. ,S,3QQ.QO
RecorRi~l~N0M-I~:Oiagor'lcm '''''IU1rssllljuob
follow rules adopted l.Jy ,i Ie Cregan Otillfy
T em ~~i!Jjii~ti<S~ ~VJilt(E:rS Ta~S'F e'e'@€L~e set forth
Ins tra.IDlWt!i!@'hpOA-J.~~~~li.Q)mro9Aa~%~-gp~ on
0090. You may obtain copies of the rules by
200 all1:P-lslr'JDmhilie:sslter. (Note: the tE$er4t(!f.lr(!J'0
v .
201 q~R'f'Ib~ptc4~~.3 '~m!p~on Utility NStIM:\UlOl
Over 401 tQ;eMLQ j@.IpPj$)Q-332-234$).80.00
Over 600 amps or 1000 volts see "B" above
JOB DESCRAPTION
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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.
2,
CONTRACTOR INSTALLATION ONLY
.
...
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Expiration Date
Jo-J- Of
C,
Cons tr Con tr. Number ,.....1~' '~cS'7C.?~
Expira tion Da te J;:)... - .3 0 - 0 0
Signature of Supervising
-r;~ '-' AcM
. I .--
Electrician
D,
Owners Name r-Jft..u~_
~v<+
Address ~~(..,O ~;l.--1
Ci ty2ptZ(~ Phone )l/I:.;-)/JO
OYNER INSTALLATION
. .!
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E,
.
Ovners Signature:
. '
~~~~;p;(Ttq~-~i~-;------------.
RECEIVED BY: ~ tiL(i ___
I - -'
5,
Branch Circuits
Items Cost
Sum
$ 85.00
, ,.
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit J
Each Additional
Circuit or with Service
or Feeder Permit
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00 :~'\ '00
$ 2.00
not included)
$
$
$
$
~".() 0
j 7-:.:i O~
40.00
40.00
20.00
36.00