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HomeMy WebLinkAboutPermit Electrical 2000-3-2 '.~- - -~ 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 oa\e . .....a\U'e d 5\9" ~\.l\no,\z.e 1. ~~~F~\~~~4 ~~2~0~laQcf) ~JO L> If) lo4 Perm' are non-transferable and expire if w k is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical contractor,4 r/0/l ~ Address r2 7 S-J <I 5'/1 t../d e r /?,..,j ,,() .' / Ci tbl./.JA1 C!?; (J '^- Phone Supervisor License Number ;J ~ t? t:, '} Expiration Date j/ 0/0/ / n./ { / Cons t r Con t r. Number .2 () / S!?L Expiration Date /0 /0/ /c'l / . . ,1" / Signature of Supervising EJ7ctrician //~~~ y~- own~ Name~X- ~ ~S Address~(~~ S~ City f mO JI.oJ Phone vi)",1' \lqg OVNER ~STALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -----------------.---------------------- DATE: RECEIPT #: RECEIVED BY: \:rr. PERKIT .APPLICATION J~b NumberJlgJj(P( oAJi. City 3. COMPLETE FEE SCHEDULE BELOII A. New Residential-Single or Multi-Family per dwelling Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular Dwelling Service or Feeder .B. 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 unit. It ems Cost Sum ( P>c:.. Sqj $ 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 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits $ 40.00 40. $ 55.00 $ 80.00 see "B" above .' New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ 36.00 \'6~f-O \ I ).'i::P. ""l. . \Q;::> \'11) .<sJJ 40.00 40.00. 20.00