HomeMy WebLinkAboutPermit Electrical 2001-9-12
The fOliaI" project as submitted has the following
zoning. oes not require specific land use
_ approve. I .... fJ
225 FIFTH STREET Zoning VVf-.. ELECTRlCAL PERMIT APPLlCA TION
SPRINGFIELD, OREGON 9747:___ '1 fE:/o I , ._.
INSPECTION REQUEstjlat'12lr-~, v> -~ vHY J3OJIlumberJ2! - nn l?"_~_', - 0 f
OFFICE: 726-3759 Authorized Signature
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'ib~9~Q.ESe~TI9.~':;:P~<!':;> '.i~~~;, .~i:.~{~~ri"~~~i1~1j}~~~~~ir'?:"\':;'~~~ :<I1')'h;"'7";i~:.~
",,-,'IJ.,-/. ,11t7l>'3,-3.ZJ..'{~1... tl-'; :., ,0.Z;J,~. , .~. ik.\...'o''\(' "'<\'" ~""_'.".--""\l.l:.r. 'i' <."W: 1.Items-:Cost;"'~Sum
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JOB DESCRIPTION 1000 sq.ft. or less $106'.00" .
.;s. A _ . _ _ ~ J. A _ ~ (0 ~& _0 Each additional 500 - -
~~ a;;' sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manufd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
.
$ ]9.00
$ 50.00
2. CONTRACTOR INSTALLATION ONLY
Electrical Contracto~e PD"'~ ,.:)'~
Address .pn~n]l. _"l~_"''"'l
~
Cil!'tIJ'1.u.O~ Phone.'::\~I4>~(
Supervisor License Number j ,3.q.;), ..'S _
B. Services or Feeders
Installation, Alterations or
Relocation:
. "C.J2.;
E"pirationDat-;' 'I'D ~DT ::'-Oi
Constr Co~ii. Nuinber~ I
Expiration Date C\ - (Y. - 04-
200 amps or less
20 I amps to 400 amps
40 I amps to 600 amps
60 I amps to 1000 amps
OVer 1000 amps/volts
. ..' RecOl\riect Only .:
-L $ 63.00 10-3 "'"
$ 75.00
$125.00
$]63.00
$375.00
s" 50.00
C. Temporary SerVices or Feeders
Installation;Altenitioii or Relocation
Signature of Supervising Electrician
'f. z1 ~~ (() fYLt-v
C'1
Owners Nam"li. ~
200 amps or less'
20 I amps to 400 amps
OVer 40 I to 600 amps
OVer 600 amps or 1000 volts see
"Btl above
$50.00
$69.00
$100.00
D. Branch Circuits
New, Alteration or Extension Per Panel
Address
~
One Circuit
$43.00
~
...-,
\l)
Citv Phone~ .l.f3:io
OWNER INSTALLATION
Each Additional Circuit or with Service
or Feeder Permit ~$3.00 ~
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lightino
. . Limited Eriergy/Res
! lCimitedEiiergy/Comin
$50.00
$50.00
$25.00
$45.00
Owners Signature:
190 : ~3IHS~:J
: 39N~H:J
g~'6L $ G:a:J3~ lW~
100G 1,>0 d3S:31~a
96g9000-10:#SN~~1
J:" I;
c)la ~ '1. -'7'..R ?-S\o-e>(
\i ...
~""-'-<l.'A_+
TOTAL
(d,'" '"'0
l.../'if3
s;"US'
}(., II
5. SUBTOTALOF'ABOVE
7% State Surcharge
8% Administrative Fee