HomeMy WebLinkAboutPermit Electrical 2000-8-3
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AMT RECD:2 $ 38.50
CHANGE:
CASHIER: 059
ELECTRICAL PERMIT APPLICATION
City Job Number ClO-D I IQ.:2.-() {
225 FIFTH STREET
SPRINGFIELD. OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
"'>350 Gq~u)Q'" s+
LEGAl. DESClUPTION
1-:::rc9 ~9..d,d, () n l::wn
30 COMPLETE FEE SCHEDULE BELOY
Ao
New Residential-Single o~
Multi-Family per dwellir.g unit.
Service Included:
Sum
JOB DESCRIPTION
Hems Cost
$ 85.00
1000 sq.!t. or less
Each additional 500
sqo ft or portion
Permits are ncn-transferable and expire ther.eof
if licrk is not start<!d wi thin 180 days Each Manuf'd Home or
of issuan~e or if work is suspended for Modular Dwelling
180 days. NOTICE: Ser'Jice or Feeder
2. CONTRACTOR INSTALLATION ONLyTHISPERMI...B,. Services or Feeders
AU-r-H IbHAlln'slt'aJ..1ation, Alterations
I, ORIZ~ -"" ",... ,,,':r
Electrical Contractor Dr:1D<0 J;1J:r, c;:DUNDBfn~elo'cHi::ls-riNOR/(
vv,vlIVlENCED IS PERM/TIC::~,
Address 33 ?,~J., IV Ivf~Nv1~^_-_ OR/&09A.~EJP~~E* l'es~T
-, ""MY PER/02pl amps t-oJ:@AO amps
Phone-2!9.~-2.I./!i.CL ';;01 amps :0 600 amps
601 amps to 1000 amps
SuperVisor License Number ~-~ Over 1000 amps/volts
Reconnect Only
Expiration Date 10-( -0 I
C. Temporary Services or Feeders
Constr Contr. Number 1-,;;'g111 ., '~.., Installation, Alteration or Relocation
" .:-" 'ulesaaDO;~db "" '''4UHb./v....
(- 1<(<; --'5'ratlor'CAnto, fh Ythl1~~I;{'i~less
, ~'''''''Y52.nn7. DserllteS6I \)\400 amps
of Supervi in lliifh ~f:~,m b010throu!ft/l;9J!, , t, 600 amps
~ ,elll/. r - ~ 0 tarn CD/Jie9'61th "GQps or 1000 volts
, _ "'l ., ^" tel,(NDte:thete rU/esb,
,""-' I, /:~,:,:~egOiIiJ/Jtiliry:M~ih~e c:.u its
?;1""""hA \bt'ili,~,""'(l-""~'::>1d"\ cation ,
AddreSS ~ 65 ~\'<IL,-, ~ New," Al tera non or Extension Fer Panel
C. /_ ",.......e, " I i.{'C -:> r.rr One Circuit _.-1_ S 35.00 35
lty c;~s - Fhone__':JU~;/-.'> ~Ll)b Each Additional
Circuit or with Service
OVNER INSTAI.LATION or Feeder Permi t
City CJ'~"Wi'-U-
Expiration Date
The installation is being made on
property I olin vhi~h is no! intended
1D! sale. lease or rent,
S 15.00
$ 40.00
S 50.00'
S 60.00
S100.00
S130.00
$300.00
$ 40.00
$ 40,00
$ 55.00
$ 80.00
see "B" aoove
.'
$
2.00
Eo Miscellaneous (Service/feeder not included)
-Each i~stallation
Pump or irrigation S 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res ----- S 20000
Limited Ene~gy/Comm ----- S 36000
Owners Signature:
------- ----I: -t-- -------- ------------- ---
DI,TE: g(rloe
RECEIPT 11: ,_~'t~L__________
RECEIVED BY; __ IJJ
5. SUBTOTAL OF ABOVE
; ~State Surcharge
3% Admin15trative Fee
TOTAl.
~5,oc
'J .c-L "i
/.05
-----3% . 5 6