HomeMy WebLinkAboutPermit Electrical 2002-5-2
'llJ.91'owing
JQ!l DESCRlPTIQN . ..l'ect al; submitted ha,sctfMlll'lJIltlft. or less .
~ A-I a dA-.M~ 'l'~lIoW>>fJkiiot~pecll Each addilional 500
. "zonl~;~a\~.t' ~ L.~ _Sq. ft or pndion
PermIts are non-transferable'\\Wd exp~gning _ thereof _
if work is not started within 180 days '5 ~ d-~O '2.-, Ea"n Manurd Home or
of issuance or if work is SUSp~d.f<.1 -;6J M""..lar B.vtlling
180 days. Authorized Signature - Service or Feeder
;
.
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
I. LQCA TlON OF INST ALLA TION ;'\
/;;0 'f t:l=-z L y IS LV u
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LEGAL D"ESCRIPTION
170..s 3,1-( I L( DC> '70 0
ELECTRlC.liiRMIT APPLICATION
City Job Number () 2 -c::n::) i{ 6b - 0 I
3. COMPLETE FEE SCHEDULE BELOW
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
$106.00
$ 19.00
$ 50.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
(i 1 (" , ~ Installation, Alterations or
Electrical Contractor L/l!f,,,Bt:Ohi61.,}..rC . Relocation:
Address <P.D. ~ \4~2--
CitvC:;?Yi~~eld Phone iY\ -2-']310
Supervisor License Number ~4.s:
Expiralion Date 10 II ! 04-
Constr Contr. Number ?K4-0
Expiralion Date t1 \ \ I OJ-
Signature of Supervising Electrician
~
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~
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Owners Name ~ SL.E.r"lA. ~
Address 613. S '71-"'- AYE
City 1~/L"_4 Phone SiJ'7-'i'5'f - Z6'i:'"8"
qwNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~oo: iJ3IHS~J
: 39N\!HJ
S~'9SZ $ Z:OJ3iJ lW~
ZOOZ GO .wW: 31\10
S088000-10:#SN~iJl
200 amps or less -.L $ 63.002
201 amps to 400 amps $ 75.00
40 I amps to 600 amps $125.00
601 amps to 1000 amps $163.00
Over 1000 amps/volts $375.00
Reconnect Only ---:='~d';;0.9j)~
An\:I\I'10,'!:\Jr"\j~"I.a.~;"-o~ego~ Utility
C. Temporary SffiY!~ orlEee<li!ispted by I e les are set forth
Installalion; ilteralio(\lOLReloa.tfdrtose ru hOAR 952-001-
i~ OAR952-001-001 0 thrO~~s of the rules by
200 art''p~j/J'.I~..sj may obtam cop' ., - 'J,~<b@P.!L-
201 amps<ls.\~9.l~ainps:enter. (Not~..~::v ~~~?:ml.t\nJL.
Over 40hl~\'~BQ.~i1)pshe.o~e2~n ~~~~'~:;!40.0.00_
Over 600 amps or,,;tOOO,voltS'See"-' . ~ I
liB" above
D. Branch Circuits
New, AIt~\~Or Extension Per PaR~ \f 'tH~ WOR'f..
One ~~\QI p~p.tA\l SU~\~ ~~~ p~~l~~~
~~HOR\lEO (\Q \' r.BI\NOONEu
Each . . ~1~UiNlt'w' L'S'ervice
or Fee I\Nf'ru\) Ol\'{ PER~' _ $ 3.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Ligh1inl!
Limited Energy/Res
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
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Sli-t
7~ ..p:
TOTAL
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