HomeMy WebLinkAboutPermit Electrical 1998-11-30
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3. COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION~......, N'orBgo~aw requires you to
";2/SD L~U.1(4 S -r sP.lm~ '': d ~~ d 9'ltHf~~~rni<iI\i-Single or
- 10Ilow",I""a ope l'Ss~o~"<ID-~lset~dwelling unit.
LEGAL DESCRIPTION Notification Center. T~erv~5~ci5~:
/7 tJ ~ :a.-7, 0 0'1 Vo'b in OAR 952:001-001? t rou s of the~rules by I terns
0090. You may obtain cople ne
JOB DESCRIPTION / calling the center. (~.t~~ tff1~tglioJess
tl.hAf- ~ V Fa Ie Q/s(!() i't.d&i?~theore9W<!Btllinl~ '118nal 500
Center is 1-80@Ql;32(.t34j . portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home, or
of issuance or if work is suspended for Modular-Dwelling
180 days. Service or Feeder
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job Number 9~N 71
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
~, /). . /I Installation, Alterations
Electrical Contractor/A', c.;-r,/ fL€.l! (,'0 or Relocation:
I . NOTICE:
Address P () &x (,~? 9 7 . THIS PE~gT'blj111~LLq"rxP1~FTHE WORK
Ci ty/}f,Lwlll1KI E. Phone ~- i" ~~~AUTHor4P:~~~~~E&T~g~[-dID~~!&N9+
601-ram";sl"to~ a(}on'~'lifp~OH
"'- COMME'""ru . ."'b" "D' .,'l~~''''--
Supervi.sor License Number Ol..j.t>S o",J Over 10 0 amps/vol ts
ANY 1BReconn'eI:;!Dron1y
Expiration Date 10// J ()~
Constr Contr. Number 3-;;;"/ L/ e..
Expiration Date 10/1/99
, Signature of Supervising Electrician
~ - . ~ ~ 4 4-L 1~
Owners Name /V}I/-RGfE- (:,oode.;
Address;:2/stl L 14-<..uLI'/ 5/ 'Sf' -:ii.9,:;.-
~. ' -=>"-1
Ci .('IIY'gA€.d Phone c;vSi' ~ ~C;-t..~
OIINER INSTALLATION
The installation is being made on
property I own which is not intended
for sal!,,', lease or ren t.
.,
Owners Signature:
DATE~---'rJ~/,ii-----------------------
RECEIPT II:. t) 'J ~ 11t"f. 4
RECEIVED BY: d W~
Cost
Sum
.$ 85,00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
.'
New, Alteration or Extension Per Panel
One Circuit I $ 35.00 .3,5': D ()
Each Additional
Circuit or vith Service
or Feeder Permit
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 3~-. () C
5% State Surcharge I. 75
3% Administrative Fee /. Id-
TOTAL $. 37. xC