HomeMy WebLinkAboutPermit Electrical 1999-9-13
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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1. LOCATION OF INSTALLATION'
/ ") '7'0 "?/OrJ S of', <<Z-
, A.
'Address ;;Z 0'1 J ~ /If orJ
Ci ty ~ lA.'1tf",-, t'J,;(.. Phone'll) J' r2 (7~9
. ,
Supervisor License Number Ib2lAcfiJ
Expiration Date /0/01/ 2uz:rD
'/ C.
Cons t r Con t r. Number ,.)" I!{
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
Q- '~-'19
~~
ELECTRICAL PERMIT APPLICATION
, Ci ty Job Number~
COMPLETE FEE SCHEDULE BELOV
3.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
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
I terns
Sum
LEGAL DESCRIPTION
..il:..t')~. 1...7. ()(J. ~ '
, ,. ,.1 ',re" I/Q..to
JOB DESCRIPTION 1-\[ ,.:.1>11',-" d '(\T~" b\,',l()OO,' SQ. ft. or less
Srla:::- followfules.a C'.~ ," Each additioriiil 500
"'ot\1lCal"'"'''''''' SQ. ft or",portion
Permi t are non-transferable(and~exp'frei1J':r,~,thereof ,L, V
if work is not started wi thjl!111180lldays' o\Jta:f';;' Each Ma..n,uf,~ d Home, or
of issuance or if work is susp!iiidgdh(f6i)nte'~ ~'. 0 . ,1;I?~1.]~~,rit(R.If,~lling
180 days. number for the; 0.", ,J$erVlC!! or Feeder
Cp~,.." ,:'3~' .
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
1'1 ("', Installation, Alterations
Electrical Contractor $.4 /1'-'" ,{,o'/II ,)17"'5 T,.c.or Relocation:
Cost
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
"
Per Panel
35.00
$
2.00
Expiration Date :J./'l/::Zool 200 amps' 'or less
NOTIC~ 201 amps to 400 amps
Signatur~e of Supervising Electric~ &;;: Over 401 to 600 amps
J L? . ~ ISPl:RMITS/-lover 600 amps or 1000
'_ . r ....1"d~ /.U~ AU:i:JGAIZP" ~LLl:XPIR1=Ir:'7"tJ~'
- COMM '-ullJN1}8ffl!nCt'tcunWORK
Owners Name U !JS.l. /, l:NCl:DORJ~ /10 SPl:RMIT/SMn-.
. IVY 180DAYP ~AA~wn''Ot' Extension
Address /940 ~n tSf. ~ Uf> l:RIOD. UR
, One Circui t $
Ci ty ~"';^1"....,tt Phone "fCJ- '2.32.0 Each Addi tional
~ Circuit or with Service
OVNER INSTALLATION or Feeder Permit
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting--1-- $ 40.00 ~-
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE $40. -
7% State Surcharge ~ ~.~
3% Administrative Fee -- I.~
TOTAL .:t>~4. ~