HomeMy WebLinkAboutPermit Electrical 2001-5-2
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The following project as SUb.~ sBpecifiC land use
zoning, and does not reqUlr
approvaL" '~ W .
Zonln9 . -
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" - ~,~ I E~CAL PERMIT APPLICATION
AuUtOrlzad Signature ' .
Date
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
City Job Number O(-CO'll.(g ,-or
3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF ~TALLATION
~(,,.gO _ \~6X_ ~4-~
I '60'2.. {) 61 Z " 't.. 700
LEGAL DESCRIPTION
~t\"~LA<: C0....,i\~ ~~~~"\
JOB DESCIgPTION
''In,l Flit...>:" ....\A'-"^ ~1I<;:~'
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A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor r L:'~ ~,.J(
Address t;.~c.1>~; s:r,IJ~,~,(..I/,
~ e<-- /
City Phone /
Supervisor License Number I ^'1~ D~
Expiration Date \~ /Ol/nZ
/
Constr Contr. Number
"Expiration Date /%r~z-
/
Signaatur,e of Supervising Electrician
..~f"1.~t.u~
Overs aLll..f" ~.... c,\;o...i'-. <:;.cJ.-.cill">
Address l '6 '\ D /oJ. '"t~ ~
City S.Pl\:"'i~iO-':> Phone '144- (,,375
{
OYNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
r-4~ <1 r. '
~~~-~-~~~-----------------
RECEIPT 11: c:, , Z. y
RECEIVED BY: ~
Items Cos t
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home, or
Modular Dvelling
Service or Feeder ,$ 4().00
,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
$ 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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" a~
"
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00 3S'?~
$ 2.00
not included)
$ 40.@ ,
$ 40.00o::<i '
$ 20 oo=.~
$2,~~~2
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