HomeMy WebLinkAboutPermit Electrical 2001-10-25
'ne'OI/OW'-" I
zoning t" ng/,o ect 8s submitted has the fol/owlng
appf8ii- oes not reqUIre specific land Use
1"9. L-DIZ "
225 FIFTH STREE1bate -_.1.0-.:;}? . 0 I I
SPRINGFIELD, O~.GQN 97477 "" I In Ii. ./
INSPECTION REQifflglf!z7'2tf-~6tyreU<..~ Q!r.Job Number f>/- 00 ~5~ -0 I
OmCE: 726-3759 '*
3. COMPLETE FEE SCHEDULE BELOW .
1. LOCATION OF INSTALLATION
. 1. \ SD VA UnA Sf. '#!J? >n A. New Residential-Single or
Multi-Family per dwelling unit
Service Included:
LEGAL DESCRIPTION
nn "'> 7 -, I ()f?A. x:t:F 04-4 tD
JOB DESCR1PTION
lith{trJ t2I1P/ll)11 'i- f'.,irtttHtr-CL
. u 1 hLa' (Jk.f17p
Pennits are non.transferable and expire
if work is not started within 180 days
of issuance or if work. is suspended for
180 days.
Supervisor License Number 0/1.5/ 5
ExPiration Dare
'''ID-/-o'l
Constr Contr. Number /.5 {, ~"o
-~_","'I .' ...,.,
.
Expiiation Date
'/l- 2.S - b?
~~;('0
The installation is being made on
~."~_../ 1 own whiCh is not intended
for sale, lease or rent.
Owner.; Signature: .
Gm:~l3IHS(jJ
: 39NtJH:J . '
OG'SL $ G:Q:J3~ lWtJ
, ~OOG ~G d3S:31tJQ
69L9000-~O:#SNtJ~1
.
ELECTIUCAL PERMIT APPLiCATION
C. T -T--"-" Services or Feeder.;
Installation, Alteration or Relocation
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited EnergylRes _
. , ' '. Limited Energy/Corom
Items Cost Sum
$106.00
$ 19.00
$ 50.00 .
. . - -" ~.
, ~, ("
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or' Feeder
- - i...,........~;..'II. -~,....--:'"
2. CONTRACTORINSTALLATIONONLY B. ServicesorFeeden;.
j0f/JA. Installation, -Alterations or. "
Electrical ContractorJ'JlJJ /fAlVlltfp r&a!tJ l;/t'eb7c., Relocation::.~;' >'::~.. ;
Address pofnx 'Blo I 200amps~~i~~~~.: '". ."
~ 201 amps to 400 amps ' ,
City~Vl c..r Phone'?O~' ~PlR'74D8 401 amps to 600 amps
601 amps to 1000 amps .
Over 1000 ampslvolts
ReconnectOnly . .'
",'
.. ,. ,T ::'HALL ~99J~prorleSsWORK
.' .... UNDEp,2R~WW!~\~qol~jT
Signature of Supervising Electrician ;. ,': <" ' .' " OVer'40l'to 600 amps
CL.' "i .:) OR IS .Q:Vei600'amps'o'i[J000 volts see
1.1' . , .' ~ "BII above
M<Y 1~:' .~.\'( PERIOL>.
. D. Branch Circuits
Owners Namemk ct- tJOh4} lun Jt..cr New Alteration or Extension Per Panel
Address--LI Pf) U'.!t.U/1/J.., r-t.# {pf<, One Circuit' L $43.00UQQ...
ci~~~fi.cld Phone~BOZ? Each Additional Circuit or with Service
o STALLATION or Feeder Permit $ 3.00
,
--.:.... $ 63.00 ~
$ 75.00
$125.00
$163.00
$375.00
---..:. $ 50.00
$50.00
$69.00
$100.00
$50.00
$50.00
-L $25.00 Z':'l.J:JI:l
$45.00
Minimum' Electric Perinit Inspection Fee is $45.00 + Surcharges
5. SUBTOTAL OF ABOVE
7% State Sun:hJlrge
8% Administrative Fee
TOTAL
195.~
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