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HomeMy WebLinkAboutPermit Electrical 2001-6-14 . 225 FIFTH STREET The lOllow'og pro' SPRINGFIELD, OR 97477 zonmg end d ,eet as submitt. (541) 726-3753 approvei oes nol require sp~ h.~s the lOlloWing FAX (541) 726-3689 C"'C land 9 7 ZOning_ LD~ use ELECTRICAL PERMIT APPLICATION ~_ (, - "-( _ c) t .city Job Number DI-o 0 32 7"-0 I uthorjzed S' eJ< Ignature _' )1 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 LOCATION fJf n;sTAL~, TION crJ z:... i:fLL/4/' l"l , LEGAL j),ESCRIPTION /-m3?f:,r3 6C(roc..:::> JOB DES.';RIPTION r (J It _ ;S)fJcf" -f-iJ.Mlllc/ rl,(.{).eJ~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 1. 2. CONTRACTOR INSTALLATION ONLY B. Electrical contractorC~ ~t1('..<jk.. Ek& Co Address P () ~ f 421)/ (0 Ci tYCL<ffAu- OR.. Phone '1(,1 t.SCio Supervisor License Number ~~ S Expiration Date~" Constr Contr. Number 13'/<;/2./ Expiration Date AfJ~/~()1 Signature of Supervising Electrician ~n.!- &!)/'.PfJtf0 Owners Name c-,)(,.v/leW LoL.~~ Address. 4 ( :3 ~ L i5:-d ~ tJ,'1 Phone ?( 7 - 703 ) City C (/1:::/\ vwn~ INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -------------------------- -------- DATE: c;:;G('-IO / .~1. .\i RECEIPT 11: ) v' 7 RECEIVED BY: ,...,~ FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Sum Items Cost 1000 sq. ft. or less I Each additional 500 sq. ft or portion thereof / Each Manuf'd Home or Modular Dwelling Servicejor 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 $ 85.00 <gS $ 15.001012 $ 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 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 see liB" above New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lightin~ Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 not included) $ 40.0iD $ 40.0(ti -l $ 20.0aJ"DD S 36.0mCriUi c. ~ />//(fA ;:,~~ ~=1--'6 ,J.;..=~ .0 ..........-:;0:01--'- C) /' I /6m ~ ,J f:g I .:--:l~........""'" ~.C)"""".p.