HomeMy WebLinkAboutPermit Electrical 2001-2-12
,
C- Q...../
1.
LOCATION OF ~STALLATION
/ ! 6 t) L.+I.(.~IQ.-- .rr-
LEGAL DESCRIPTION
/7032710 0'730D
JOB DESCRIPTION
{Vlf'V1,/ /"IIl'R/ ,P~ s
Permits are non-transferable and expire
if \Jork is not started \Jithin 180 days
of issuance or if \Jork is suspended for
180 days. ~ J Ip 7--1
OYNER INSTALLATION
The installation is being made on
'property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
OZ''lO/
vl4Z- I
'rP
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726.3753
FAX (54 I} 726.3689
ELECTRICAL PERMIT APPLICATION
City Job Number o/-oo/lb-Ol
3. COMPLETE FEE SCHEDULE BELOY
A.
Ne\J Residential-Single or
Multi-Family per d\Jelling
Service Included:
The following project 85 submitted has the following
zoning. and does not require specific land use
approval.
225 FIFTH STREET Zoning
SPRINGFIELD, OREGON 'DMi/7;;C- I~-O'
INSPECTION REQUEST: llu?l/;n~Jo6~gnat If ~
OFFICE: 726-3759 u
2. CONTRACTOR INSTALLATION'ONLY B. Services or Feeders
-'" - r r(),/o Installation, Alterations
Electrical Contractor~, .)-'))--/ \-L'T...K.JJ-. I~17l2.or Relocation:
Addresstl) NoS I, ), I r'-h ,i:\::; I ~ ' 200 amps or less /
__ '. . 201 amps to 400 amps
Ci ty/:::"UC en(? Phone(iJL:f. C') 7- -:;-0 401 amps to 600 amps
/J ,Q 601 amps to 1000 amps
Supervi~~' License Number" ') <[,"1-/;1 ~) Over 1000 amps/volts
i ' Reconnec t Only
Expiration Date i() / I /0/
. ,
Constr Contr. NUmber\':)-:t-~R7-C:
Expiration Date ID/t /Ili
Signature O)S~ Electrician
/ l? r- D Branch Circuits
O\Jners Na..6 ! r I ~~t t::)(~ {i. _ .
Add res s '( ~ b> 0 L/J.;,A Il..,o <;" r-
Ci ty S frO Phone 7<f7- 76 ['2...
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular D\Jelling
Service or Feeder
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
So. cD
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
Ne\J, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or \Jith Servic7/
or Feeder Permit ~
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$
)r.6D
2.00
not included)
$ 40'~
$ 40. ",,::j
$ 20. D
$ 36.~ ~r
~ <v"" -n ..
mo~:3
>-<~-<&>~
;;0 19 bf- t:n5
ro-ii,~:f;:
-..,..:.... 1.......___..,J
t-u o........~