HomeMy WebLinkAboutPermit Electrical 1999-10-25
The following project as sUbmit~epde~~~ t~:n~I~:ing
225 FIFTH STREET zoning, and does not require {) ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9jg~'fval, \~IJ \),"'. qc; ,
INSPECTION REQUEST: 726_3769'OIn\0 ~.~ 5-CJ q r.' ty Job Number I I )fl{ 7
OFFICE: 726-3759 Date 7"
f.\U.lD~rl1.~O Signatule ., ~911PJ:.E'l'C FEE SCHEDULE BELOY
1. LOCATION OF INSTALLA.iUN
53/ S- [$6,/f ,A. New Residential-Single or
Multi-Family per dwelling unit.
LEGAL DESCRIPTION 5 Service Included:
I,,,", ~5 "3 I () 106 Items
JOB DESCRIPTION 1000 sq.ft. or less
t~~7, ' Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
Permits are non-transferable and expire
if work is not started within 180 days
of issuance 0" if work is suspended fo"
180 days,
4!
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
''In'TICE' / Installati?n, Alterations
Electrical ContraC!tM- . or Re1ocatlon:
THIS PERMJYSHALL EXPIRE IFTHEWORK
Address 0dJT1 ~rf!:C ~~JD=o.TlJ'~ OERMlTIS~OOramps 0" less
, . 2b~'amps to 400 amps
COMM6Nli:EDORISABANDONEDFOlilol amps to 600 amps
, .D.iY180DAYPERIOD, 601 amps to 1000 amps
Supe"viso" Licens~'NumDer Over 1000 amps/volts
/ Recgnnecfo Only
E '_. ' D t '\TTENTION:Oregon law rC4ulI"" yvu ,
xplruclon a e ,.. \" ,pnonUlilit
. / tO~I?W~Uie5i:1UUfJl.,db.cJ1e1~1!1'p'g!:!'l;y"~Rrrvices or. Feeders ,
Cons tr Con n. Numbe" Notlhcat!on Center, Those rullns tarIa tlon, Al tera tlon or Relocatlon
/ in OAR 952-U01-UU1 0 tl,rough UAH~o~-UU \-
Expi"ation Date (\nQO,Voumavobtaincopie~66hariip\f:.JrY1ess $ 40.00
/. cai"q '~he center. (~ote: tl20'lll~ihps:fto 400 amps $ 55.00
Signa ture of Supervising Ih\.llli~e;i.9.W,1.; Oregon UtiliQ,v'ej;tt~01tIC~-o 600 amps $ 80.00
I ' Center is 1_800-332.0:v.e~).600 amps or 1000 volts see "B" above
City
Owners Name ,I . \
IJI (A! J (' A t'JL S
i.elJ'i AS r.
Phone;;~" -II 71
4~ /L{"
CitY~Cj
OYNER INSTALLATION
Address
The installation is being made on
prope"ty I own which is not intended
for sale, lease or rent,
Owners Signature:
T ------,;7;:s7j1~----------------
RECEIPT II: IJ~ r1l.( J tf
RECEIVED BY: W~
D.
Branch Circuits
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
. .
New, Alteration or Extension Per Panel
Miscellaneous (Servi~e/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit I
Each Addi tional
Ci"cuit 0" with Service
or Feede" Permit
E.
5. " SUBTOTAL OF ABOVE
7% State Surcharge
3% Administ"ative Fee
TOTAL
$ 35.00 15
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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