HomeMy WebLinkAboutPermit Electrical 2001-10-24
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225 FIFTH STREET
SPRINGFIELD, OREGoflu1mlli1 SIgl1arute
INSPECTION REQUEST: 726-3769
OFPICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job NumbeOI-Q09'07-Q (
3. COMPLETE FEE SCHEDULE BELOY
LOCATION OF INSTALLATION
lID q S" 40 uklt'h
1.
New Residential-Single or
Multi-Family per dwelling
Service Included:
A.
'i
unit.
Cost Sum
$ 85.00
$ 15.00
,$ 40.00
LEGAL DESCRIPTION
17o-s3 '--!t(3
o <7/cr=
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dwelling
Service or Feeder
JOB DESCRIPTION ~
1-IMk fM? p~ to f)wn;~
v
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
Electrical Contractor IMdro ('vpsft"Y'Yl
Address ?15.3 S, 5-+1-, :# 175"'
CitY~/'^"ir,& Phone 7'16-3512-
Supervisor License Number 558 SI'1
Expiration Date /() - 1- 2~2--
Constr Contr. Number 12 'i? 5'1-'
Expiration Date 4- /5 - 2..&0 /
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Services or Feeders
Installation, Alterations
or Relocation:
B.
.,
.I.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$40.00
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
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Si~~ectrician
Owners Name :~ ~,~_ kJ/Kl--~ 5?",~-!{D.
\?}vd.
Branch Circuits
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New, Alteration or Extension Per Panel
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/..-rA-v-. r:-fr:.
Address LID '7 '\
One Circui t " $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit $ 2.00
f::1A.G-
r _X6'>7
Phone
City
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OVNER INSTALLATION
.E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.~GO
Sign/Outline Lighting $~0::'~G-->
Limi ted Energy/Res S 20.jO'p:::: '?"
Limited Energy/Comm $ 36.~~
55 ~
5. JiU!lJ'OTAL OF ABOVE . ~',H'-., __ I
7~ State Surcharge S~~.
.g~Adminfstrative Fee .. z::3r..:Jcr--
TOTAL---'--~~ \
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------y;- --~----------------
DATE: / D r Q / c::> I . <' ,(---7
RECEIPT II: / f~ '/ ~ {
RECEIVED BY: ').12