HomeMy WebLinkAboutPermit Electrical 2001-8-1
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The _Ino project 8S submitted has the following ~
loni d does not require specific land use
225 FIFrH STREET epptO . ELEC \\L PERMIT APPLICATION
SPRINGFIELD, OREGON 97477zonlnr ~ AI _"flCJ ../
INSPECTION REQUESTi 726-3769 ~ I I I () (. .L _City Job Number U -r.K/ ,69' - e /
OFFICE: 726-3759 ate . . I:Y':...
Autheti."" SIgnature ])tlA, f"QMPT lOTI' =l'; SCHEDULE BELOW .
1. LOCATION.oF l}I~~LATION J
.;2 ~-r k"d:t::A. ~ r;,../; A. New Residential-Single or .
Multi-Family per dwelling unit.
LEGAL DESCRIPTION I~ NOD Service Included:
,..., O'?:> '2--1- t.l-I u VI Items Cost Sum
JO!JJD~SCRij'FON /.. I ,J[~- 11. _ ~
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1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$106.00
Permits are non-transferable and expire
if work is not started within 180 clays
of issuance or if work is suspended for
180 days.
$ 19.00
$ 50.00 .
2. CONTRAcrOR INSTALLATION ONLY B: Services or Feeders
. . Installation, Alterations or
Electrical Contractor k 5 EI t"',-I..O...LL. " ('GM(,,-If;~. Relocation:
Address (}. 0.' '(3;.,y L V? 3 :J 200 amps or less
20 I amps to 400 amps
40 I amps to 600 amps
60 I amps to 1000 amps
Over 1000 ampslvolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Cityy u r.."" c;
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Supervisor License Number 3 t/~7.f
Expiration Date J ~ j'/ /0/
Constr Contr. Number 7o.? J- 7
Expiration Date' /~/ 3 %~
Phone".f~ -(;2.J ,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
20 I amps to 400 amps
Over 40 I to 600 amps
Over 600 amps or 1000 volts see
"B II above
$50.00
$69.00
$100.00
Signature of Supervising Electrician
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Owners Name1ldN ,:e\l c)"O / (M,f IJi()sk ;
V
Address~.5 K'cd:I,.fJ2P.NV /3v:I
City~ ~ Phone'11(7'1t:J7~
o INSTALLATION .
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit
-1- $43.00 _
Each Additional Circuit or with Service
or Feeder Permit -L-$3.00_
"The installation is being made on
property I own which is not intended
for sale, lease or rent:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
Owners Signature:
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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." $ e:O::J31J lWIj
1:00e 01: 9nlj: 31ljO
tOv9000-tO:#SNIj1Jl
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
4-i",uo
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TOTAL