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HomeMy WebLinkAboutPermit Electrical 2002-8-15 - 225, FIFIH STREET: -, \-\ i ',: EutllCAL PERMIT APPLICATION :\-. ~ iSPRINGFIELD,OREGON97~7?i.._J: Ii,.,....,' t, " , INSPECTION REQUfST:, 726-H69, -, : . 1 i City iJoh ~umher02-atl44~-OI " " Of,Fl;CE:, 726-~759, " ..: ' '. ::',.; 1 " i:-~_ ~,t COMPLkTE FEE SCHEDULE BELOW I. LOCt\TIONOFINSTAL~A+ION Il'! . H' ~'415 .j'Ae.cB LANI. . '." .' l__~ 'A. Nc;\,'Rcsidcnti;t1-Singleor----':'" - ~- ~ Multi-Family per dwelling unit. LEGAL DESCRIPTION 0 Service Included: /70 z.... 3'f II /35'0 , thetollOwing , . submitted has following prOject as . specifiC land use JOB tloSCRIPTlON :;~~and does not reqUire 1000 sq-Et. or less \..~e- W I ~vaL. !:,l'::"\~ F'u>h aelditio.nal 500 J .zomng ,<;' - CJ '2- sa, ~lOn Permits are non-traasferable and e"Eire US,..,t: LJ thereof if work is n~t started within~B d~ys . sture ""-l.-vv- Cdl.1l1v13rilird Home or / of issuance or if work is susIMIaealf01 Sign Modular Dwelling /. 180 days. Service or Feeder l:90;(j3IHS\KJ :3!JN~H:J Ot'60G $ G:a83~ LW~ Gooe; ~1: 3n\i;31~a tOtOT.OQ-1:0:#SN\iHl 1- , \"--~' ,: I Items Cost Sum $106.00 lOb ..L ~ $ 19.00 70, $ 50.00 -=-- 2, CONTRACTOR INSTALLATION ONLY / B. Su\'ices or Feeders J Installation, Alter~tions or 'Relocation: Electrical' Contracto~_ ~!I\lt 1fI01lt.ITttltol e.\.Ee.TI\It . . . I." . Address~~ 9\'2. ; ,'... \ // City~f.\A) Ii.\:L .()\Phone .SAI-74I-I144' i , Super\'is~r Licen~eJNumber <<~.jUlg. , I j 200 amps or less 201 amps to 400 amps 401 amps to GOO amps , /, . 60 I amps to 1000 amps Over 1000 amps/volts J Reconnect Only , '; \..\ $ 63.00 ~ $ 75,00 _ $125,0.0 -'------ , $163,0.0" $375,00: , $ 50.00----'- // 'J Expiration Date / L..ConstrContr, Nunlbef c. TcmlloraQ'Scn'icesorFccders Installation, Alteration or Relocat~'\N(}~~' , ~ :' ~ \i'~ S ~Q' -. ~OO amps O\li't'l-?\'rI. ?t.~\lI\' ~U'- - $50.00 _ '_ ''''Q1\t.~bi~~~lf ~ Q~t.'i) i ~ $69,00 _ " 'c;,-?~' Uf/1,'i6 ~~'V. _ $100 00_ \\'\\'I\\S\~'\YiIl~~~\)~?.o volts see' . r>-~()\lI~~\):~r>-'l ?t.~\() .- - - '.. . D. JMh'/,dJ Circuits '10\)\0 New Alteration or Extensio\'t1>er.]a~i~i....,. i I; '\~J \V~ gp" ,0'-" I" ..,t'oll ~eO~e esG\ ~_ Onb(j:llCi'iit- d'o'!~ ~eSa.~ cc..,..Q1) $;\3.00 . \~\~\~: a.do~.e1"~Ose~\l ~OIl-~~-'u\cs'llJ ;;.' E'M<\'SAdd' ,( I"" _..'0: , Ii"S<il \. e "ON\l lie 1 ItlOna ~\!:.1fCU1t'or. WIt ' ervlce\ \0" ..<\v- ",,'v- ,6"- ~e\l". ~ ' "\C'.9T.'Feede!j'Permit11lcoQ .~e\e ..~,,\l$ 3,00 _ ~O\I'. o~'6?-" "O'OW ~O\e'. ~. ~O~"'- n."'" _., ~a., _.",f. \ ,'''\1\'1 . . .~ E:lIl\1lSccllaneous ,(Scn'lce/feedcr not, mclu iled) 0'<>'" 'I''' ~ "'-"6"'- ~/..- '-- o fl\gach'io~till.latio~ r,'JO:!?J P !;Ulup'tof\rrigotibn" " O\sig';vo~{jrri'e Lighting Limited EnergylRes Limited Energ)'/Comm ~-"- ''-" E . , 0 .... XpmltlOn ate --.._-- -'- -- Signatll-reof_~lIpcrYising Electrician Owners Name tIIA'Qu. FAfoT' ", Address~IlIQ.i. ST, City ~UGlJ.\l:. IOQ. Pho,ne.S4l. M4.,QIAl OWNER INSTALLATION The installation is being made on property I 0\\'11 which is not intended for sale, lease or rent. $50.00 $50.00 $25.00 $45.00 Owners Signature: "mahH ;!3d - I\'Iinimum Electric Permit Inspection Fee is 545.00 + S~lrchargcs 4. SUBTOTAL OF ABOVE 70.10 State Surcharge 8% Administratirc Fee j$Z 127'1 /'-(Sb 20 71)3.- TOTAL