HomeMy WebLinkAboutPermit Electrical 1999-3-8
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The. fOllowing project as submitted has the following
zonmg. and does not require specific land use
approval.
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number"'f q 'lID I r
225 FIFTIl STREET
SPRINGFIELD, OREGON 97477 Zoning
INSPECTION REQUE'ST: lJ216~o
OFFICE: 726-3759
0-(1_
3- \( "'-.CJc:
Autnorized Signature i:1...J
.L
1. LOCATION OF INSTALLATION
O(lP9 KRUSE:... Wp..y A.
tiGAL DESCRIPTIOJ 703;2:.2. ,).{).Xf107-
CaV\~~," SU\\E.S \ \, ~,;:::.\
JOB DESCRIPTION
~\ ~ AL:f>..<~ S~
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 B.
Electrical Contractor NA.T\oNAl- F\~
r\(.r~ ~
Address2bl \ W,C:;-Ti+ <:''\. I
Ci ty, Eu ("", Cf2. Phone ties-- Y::;u,fJ,
Supervisor License Number ,::;>\O\.2.E..,
Expiration Date \0(1 \q~
Constr Contr. Number \~4~~8
Expiration Date -=5.- 8-00
Signature ~~~~i~Elect~ician
~ ~O~. '-
OV~ NameLAL-O~ \ 1-.1--. C.
t:>E\.la..c~\ c:.ofZ-f",
Address'3<'\,.,C;- ~...r..n "c'" -JI.CCW 1..At---ra
Ci ty 't::>r-\\:> .
Phone ,411l - gl.//.fL{
OYNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale. lease or rent.
,
Ovners Signature:
D~;~~--~jf~jfc1fyr-~----~----------~-
RECF.Il",U ~ {'!) ~ < n /. "-
RECEIVED IlY: Jl-.1i17i J/l..:---:
ccrliPf::ETE FEE SCHEDULE BELOY
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
ATrENTION'Ore Items. Cos t
f " . gon law reqUires you to
100~J(,~1l7l~~~e~a'i?.pJ~d by the Or€s085.l~Oy
Each) !3,'A~g5ij.,^i{'fH3J)Ohu".. rUleS are set forth
sq cJo~6 9r 0'r'hlllh10 through OAR 952,001-
therpo'f ou ay obtain copies of t$elrli~y
I"amnc: 'her.o/il'" '" .
Each flanur ~(J nO e,ro".ole: tne telephone
ModG~JII!lqs~e'll11fu'grego[l Utility NotifieatiPB
Service or'3IF€el:l'e1r800'332-234'~, 40.0'
Sum
Services or Feeders
Installation, Alterations
or Relocation:
C.
200 ,?~ps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps "to, 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
'~~ <:-u
Reconnect Only '~P/~ $ 40.00
T' .. S' "'-IIt;:'F dlic WO'"
emporary erVlces or '_!!'';!.'7,rs t1/(
Ins talla tion", Al teJ;a tion or/,Reloca tion
,., (I" -v'\<:.(j 1-0 . -VI
200 amps or less ~ 40.00.
201 amps to 400 amps $ 55.00' "
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circui ts
Nev, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
/
$ 40.00
$ 40.00
$ 20.00 _ ~.
$ 36.00 <;CI DL./
3/A . 0 l)
----f. J ~
-:1'1.. f(
5.
SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL