HomeMy WebLinkAboutPermit Electrical 2001-5-3
"
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. . .tted haS th~ following
. ect as subml . I d use
The following prol n~t require speciii~ an . .
zoning, and does " .
. approval. ~C!-/ _ .-:--
Zoning- . '. ",r..EGTRICAL PERMIT APPLICATION
97477 C::_3-0\ \ - (
726;3a\69-----' q\LA..J Cw. J~b Number Of -00 '-I L '7-0
. ad Signature
AuthonZ . . 3. COHPLETE FEE SCHEDULE BELO\l
225 FIITH STREET
SPRINGFIELD, OREGON
INSPEcrION REQUEST:
OFFICE: 726-3759
1. LOCATION .OF INSTALLATION
1-13. "19 J=;.,q.", ~/,n. 11 V .L
':Ftc.' 1- ..:
-to _-=--
A. Nev Residential-Single or
Hulti-Family per dvelling unit..
Service Included:
LEGAL DESCRIPTION
17033L(LfL{
00'-(00 .
JOB DESCRIPTION
Y7A-ir . 1;0/ A-T"a.. bll""4Ge-Q
f=-Li=r::r'/Z, c../J.L
Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY .B.
. Electrical contracto[t~~Elec;\YI'G;-=H'\C,
Address P,D, 1301 il\~:2- .
Ci tx9^"i \'\Sh.f1d Phone JL{.j-223ia ;
Ito~IS
\ O-t;\-O I
, '3,?QQ
C)-Oj-D2. '
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
,"
, Sign~~e Xf.sup~rvising Electrici~, :
. \{LL: ~. .'.
'ovnetlNa~e 'S7;'v"''-'/ ~#- ..... .', .
, . l'
Address ,y6 lio, 26/z~
Ci tYb..tAC:-e7V~ Phqne. 9:)/": 5't'67
Ol/NER INSTALLATION
The installation is being made on'
'prope~ty ~ ovn vhi~h is not intended
.for sale, lease or rent:
Ovners Signature:
, . ..
---------------------------------------
DATE~ Os()~CI'
RECEIPT 11: <;'51
RECEIVED BY: ~
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular. 'Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items Cos t
Sum
$ 85.00
$ 15.00
. $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
,.
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circuits
"
New, Alteration or Extension Per
Miscellaneous (Service/feeder
. -Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
.Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Servic~
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
37. Administrative Fee
TOTAL
Panel
$ 35.00 ~...r
$
z-Y
2.00
no t included)
$ 40.00
$ 40.00
$ 20.ooo;;r-
$ 36.Q9~~
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