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HomeMy WebLinkAboutPermit Electrical 2001-11-16 . bre!, . fL~s . /'.' 1;:-.225 FIFTH STREET ;-, Thefo:I'le Ifn' "p"e,r;r;.::~b'''trt''d' h 'th" 'f'll ,ELACAL PERMIT APPLICATION , ~, ',. w 9 r Je~bm;it!ted has! e 0 oWing I' . , I ~,^"'iJ : i SrRI)'lGFIELD, OR1OG0f6M~ll?arid doesinotlreQUire specific land use .'. . 0" , , '," I 'INS~ECTION REQlJ.ES1ippli\GaF6~--, i U' v\VJ: I' I City Joh Numher .() 0 -:-00. ( 7/-0/ \..' ..,I OFFICE: 726-3759, ,1"1 : iienwnl' ,Vl<,1 ! I: I ' .', , ~:) i!t-'" : I~. II' ';'" !~I ,',' :l}' lSBOI.~:3.:... OMPLETEFEESCHEDULEBELOW .~. ',f;..., 11. LOCATlON,oF)N, Ai l~ i It12 'I. j I, .' .. ,- ./ ~~ '2 if I.( '6;-' ,.. 0,4 I~nature".', ~'~"""",tial-Single or---.. ,.. -. .,,- Multi-Famil)' pel' dwelling unit..' ' LEGAL DESCRIPTION ~ Sen'ice Included: . , , 170 S 2{...,Zl O'3I.{O') Items Cost Sum "'~~ . I . " JOBD~~ eu...~ I $106,00 -'---, 1000 sq,ft. or less Each additional 500 , sq, ft or portion ' Permits are non-transferable and expire thereof if work is not'started wilhin 180 days Each Manufd Home or / of issuance br'ifwork is suspended for Modular Dwelling /""" 180 days, :"-; Service or Feeder /, ,,'" ~ !""~' / 2, CONTRACTOR ~N~T ALLA TION ONLY B. Sen'ices or Feeders ;' J ' I... \ Installation, Alte7tions .or Electrica)" Conlractor Relocation: ' / Address f ;' ;"; ) \, ~" 200 amps or le~! ." " ). \ j, \ /: . ''-, 201 amps to 400 amps City :.. \ PI' "" 40 I amps 10;:600 amps . . l / .... ~"!' ,i I \ i ' .. . 6QI amps to 1000 amps I'.. , O\:er 1000 amps/volts " I:: " " I !:.. j E Recenn~ct 9~lY( t" to - I X,_PlratIo.n ~ e , .' , " :.', ,<...:.., ..... L C Teml)Orary Services o~Feeders f,J, l ' Constr~u';1ber , ' Jnstall:~tipn, AHe.ration!ofRe10eatipn .; \)~:dii<~ExPirationDat~'" , . 200 aI,nps or less ',,' .; ,.,,"T$50,00 'j ,..~':',>:-'i. ',>, -""'--.!;. '. .' . ',201 a;nps to 400 amps . "";'$69,.0,,0' r'\"~-'~~",:}:,\", '.,t"-...~. ~" .~ , ". . hI.;,,', ..Signatui'e'of Snpel"\'ising Electrician --------O.vcr 401 to 600 amps' ,. $100.00 r::>Z, ,,,'::. :';:---..", O~~?600 a~ps or 1000 volts s~e, ' ';,;,,( .,:::,.;; ..' ."'.' ," ,~-.,...",-~. :'B" abA.,;e, ---~'~'" ,,, y,I-I: "',' ~~ I'~":\. ;>','-', ,..,. ~ ~~~;';'.':,:.own~rs Na"!ellff{iVftV: ','~'Ar ~4W\.. D. Bra~:7jf~;;d~n ot1terision p(<~~~el". , '.' A () r:iJ H;'..n.. Add~es~'Z'tq:g: 'LAJk- \<-1-- Onefircuit \ I' . ,', ,I. "$43,00 ~ ' [:~::> Cit.yc-:;f~JvoH~ihcin;' ~ L~':~dditibnl;'~;Lt or wit~~eivice ' ....,.". " ',..,.' !'iF"d p' {t., ", \1, '$3.00 .... t~j.:~"-,.':,,,~. ',~ 4 .J 'j~J'~ ~~,fr ~!~n~;,--.:~.~~. \_, ~ " O~VNER1NSTALLATION, ,'" .,', /~"d \ \, },:i,'.," 'Theinstallatiori is being made on, E. l\lis'cellaneous (Service/feeder not included) ,,' ,.:;;': ,,'., ,property I,o\vri ',vhich is nOI,in.ten. d.e~ " !' i.Each inst,allati~h " ;!" . \... . " 1 ,}l : t.' /1 ~ '. ..! I ... 'j I \ .., ",' for sale, lease or rent. . . Pump or.;irrigatioh .~.;. I" ,$50.00 .~ , T " "i SigIV()liiii~e.Ligl;ii~:g :! ! ='$50,00 - ','.: . iO;vn~rs ~ignat.urc:' .--'~, ; IeimiledEnergyIR7s,:...' $25,00 190iiB,'lHS~%;;)VVJ ro~, ,: L._ C;:)A\Aji.~ ~'L~iii~t"d.EnergY/C~mm!:' $45.00 : 39N\1H:J' c ~I ' ' . Minimum EI~ctric Permit Inspection Fee is 545.00 + Surcharges or 0 $.':t . " , ' , " " , i,' , . l . ~j. ' OC'llJ.$ c=G[mllW\1 4. SUBTOlALOF ABOYE ' l006 n. ^ON~31\1a 7% State SurchargeL ;:: 0' crc40f~w:#SN\1ilL ., ,. (:(froAd~inisirahfeel' I :1Z\,/- TOTAL -' L1 ...,--_:__.~-.-. ..._... -----.- -. .-.._. --- . '-" 1 .,'.'.,; I ' ."" :~ ~ '. '" '. : 1 i i ',' $ 19,00 ~ .1.: \" '~ . $ 50,00 .. , ','. "\" , " \ 1 ~;' . . . ,....1<'.. ,: I',,'. , I" ' ( ;.':. ~ i ... -. .~ J . ,.,', ~. .~ '. ~>. '", .. . ;...1., ---.-:.:..: $ 63,00 :::...- I ~$75,OO . $125,00 $163,00 $375,00 $ ,50.00