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Home My WebLink AboutPermit Electrical 2001-3-6 1- \, ~\ . . The following project as submitted has the fol oWing zoning, and does not require ~pecific I~nd use approval. ~ Zoning :,-t1-01 \ 225 FIFTH STREET Date ~ ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON ~iIdiJed SignatuT. INSPECTION REQUEST: 726-3769 City Job Number 0 1- fH) .;l 0 ."..:. 0 / OFFICE: 726-3759 1. LOCATION OF INSTALLATION 3/O,(Q I-"~ ~ LEGAL DESCRIFTION l,D?, ,') U- 'lJ;:).. n .~{/.,'tr7J JOB DESCRIPTION _ Prl~ ~ 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 .B. Electrical Contractor/..la1i........x r-.'r<.~ ~~~ Address d-S II W. Sb-. ~~. Ci ty ~Cl--tu.. Phone 4g,- S~ 0 S Supervisor License Number :l.i:L73' (( Er Expiration Date J(}. 1- loo?-.- Constr Contr. Number ...- c. 7_ 0 . -=) 2. <) <'-U::: Expiration Date . si~ure of Supervising Electrician /11-. L---.. - Wfe:: Name ~Ql,^ el CV1-<...- Address 01'7 (, (:' 1"t'-tL~ ~ Ci ty ft L~ Phone _1!:U .:. L/ '4.1 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: RECEIPT I: RECEIVED BY: 3. COMPLETE FEE SCHEDULE BELOII A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or port~on thereof Each Manuf'd Home. or Modular'Dwelling 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 It ems Cos t Sum $ 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 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 "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 $ $ $ $ 41 3tr' - ri. ~ J- \ c'>~ (3,<1 . U. 0 40.00 40.00 20.00 36.00 3!L-- ~ -:.--- 1 '\0 225 FIFTH STREET ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 Ci ty Job Number I:J I - n6l.oo~ I OFFICE: 726-3759' LEGAL DESCRIFTION 1"'10?J '04 LJ;).. Oi}..081:l ^ /L-!pB DESCRIF;I;ION . ,1c...<"jC,J::...,",,", 1000 sq.ft. or less v-nt;11.- OF- 1"'\f;SL.-v c. v.... '/ I c-r " Each addi tional 500 . /I ,S I.c..LLCsq. ft or port~on Permits are non-transferable and expire thereof if york is not started vi thin 180 days Each Manuf'd Home. or of issuance or if york is suspended for Modular'Dvelling 180 days. Service or Feeder 1. LOCATION f!!}l~nAL.~TION fl ,In 2J9 LP F- IL--I....I n oLvv. . A. 2. CONTRACTOR INSTAL~~~~('A.L, .B. Electrical Contrac tor ~\ f2..E-- '\- S&GuR.\T'i' Address) c::,11 W '=:J~ a..UE-r1L)f;- Ci ty E:. UC:::rE::- (\ &- Phone L\ 9:f.:J. ~9 09 Supervisor License Number Expiration Date Constr Contr. Number 1..-0 . "?'Le:x:,LE- C. Expiration Date . Signature of SupervisiDg Electrician Ovners Name 'lo~ fLO--G c- Address~19LP FMI\'L.-Ll[) BL0D. City f-UG-&(1~Phone/'-tI.l-f r~ { OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended GtO:~31>>S~le, lease or rent. : 39Nl!H8 09' 6t QlI@~3!ligoo. ture: 1:00<: 90 ~l!W: 31l!O 61:9iJonn- TrI: !tC:~II-'\II. --------------------------------------- DATE: RECEIPT II: RECEIVED BY: 3. COMPLETE FEE SCHEDULE BELOIl Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items Cos t Sum $ 85.00 $ 15.00 .$ 40.00 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Temporary Services or Feeders Installation, Alteration or Relocation 200 aoips' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits " New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ ?O.OO $ 36.00 .~ ~lJ'.oO 'L. .??- ~~~ J'V