HomeMy WebLinkAboutPermit Electrical 2002-2-22
225 FIFTH STREET
SPRlNGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
.
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ELECTRlC.ERMIT APPLICA nON
3. COMPLETEF:~YS::E::::E:::OOI 9V_O~1 ,
A, New Residential-Single or
Mnlti-Family per dwelling unit.
LEGAL DESCRIPTION I Service Included:
170.z 3Sz.3. Dt:::>31m~npproiectass b . Items Cost Sum
U "'J", ano aoe~ nOl re u mltted has the fOllowing
a,..,~f(;V81 qwre; SpecifIC land..
1000 sq.lt~fl't less
ZOOlng _ !..pt't Each additional 500
VAte "2 - 2- 'Z-o 2 sq. It or po.ciulT
Permits are non-transferable and,eJ(Wr.~.u ,,",' , ,.(. '\ uren:of
if work is not started within 180 days YIoUlur. VIJ". Manufd Home or
of issuance or if work is suspended for Modular Dwe 109
180 days. Service or Feeder
I. LOCATION OF INSTALLATION
q{,b LAk~~VlU\ I J')~('
JOB DESCRIPTION
BL>W",j' Mo",W\
$106.00
$ 19.00
$ 50.00
2. CONTRACTOR_INST ALLA nON, ONL Y_
Electrical Contractor -AJ:lT" StLlJ'( ; ty'
Address 2.ilS Sw IS3t! Dr.
City_ Bo!lAlI~doV\ Phone5,j~~II(,1711'O
_ B. Services or_Feeders
Installation, Alterations or
Relocation:
/i -- , . ,'" hl," .J.lf. q~q,..M6SyoutO
".~ i ::";'~_,ll?'a~s-2.ness ioi Oregon Utilii\!-- $ 63.00_
Ivl,e:' ,UZOl ~W>C48~ :\",'IiFes are set fC'.!1h- $ 75.00 _
i':0tifieatir40~11lnP'itJ/;,&~cm OAR 952-0'" - $125.00 _
InOARg=60jlQrt;~1b?IIi!f6'\illlps h le3-"'1 $163.00_
J090. YDlOver.i10'O{jf8\B~{tfllR~ all e ru ,,- $375.00
ca\lingR!eeo:iiii.ecjlOIJ~'Jte: lhetele.~ho~- $ 50.00-
'lumber lor the Oregon Utility Notllicall,7" -
OHnl1ijidr8';fs~Nr.?eltPFeeders
Installation, Alteration or Relocation
Supervisor License Nrunber 7R3 i Ie
~
Expiration Date 10 -01- 0 Z-
Conslc Conic. Nrunber 5"44
Expiration Date S. 7 - 05
Phone~I'7U.'t"'
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
NCJTfE'E:
THffi flH1JIIl!lIrS'~A\!.LI€XPIRElFlHEWOAJ(
~~5'tl~b~m~ERIVlmSNOT
CQM~liDOR ISABANDONEDFQR$43.00
ANY 180 DAY PERIOD.
Each Additional Circuit or with Service
or Feeder Permit
$50.00
$69.00
$100.00
. '<!"\If/""'
Signature of Supervlsl
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Address L/hb
City sPrn
OwnersName~VltlLJ BLlil~rd.
L'A-t$MbV Lt"
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
$ 3.00
Owner~Signature:
E, Miscellaneous (Service/feeder not included)
.Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
$50.00
$50.00
~ $25.00...Z:.5..
_$45.00_
T90:::J3IHSti::J
: 39NtiH::J
gL' TIj $ G: G::J3::J _lWti
GOOG GZ 83.:l: 31tiG
vOTBOOO-TO:#SNti::Jl
Minimum Electric Permit Inspection Fe~5,oil.ct:.->
Surcharges
TOTAL
45.00
~
~
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4, SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee