HomeMy WebLinkAboutPermit Electrical 2001-7-5
.
sf~aFIELD .,-~"";,,,
" The following project 85 submitted h~~ the fo QWIO
, , nd does not require specIfic land use
zOning, a .
approval.
Zoning
225 FIFTH STREET Date
SPRINGFIELD, OREGONA,gi!.~jd Signature
INSPECTION REQUEST: 726-3769
OFFICE:' 726-3759
Permits are non-transferable and expire
if work is nO,t started wi thin 180 days
of issuance 0< if work is suspended for'
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
/
/
Address
City
Supervisor License
Expiration Date
Constr Contr. Nu
Expiration Dat
Signature of Supervising Electrician
.' i
ELECTRICAL PERMIT ,APPLICATIQN
City J~~ NumberOr-ooGb7'-6/
,B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to' 1000 amps
Over 1000 amps/volts
Reconnect Only
Cost
Sum
~c:;-
$ 15.00
,$ 40.00
$ 50.00
$ 60.00
$100.00
S130.00
$300.00
S 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
, ' D. Branch Circui ts
Owners Name AA/C- , L !) I~(or,,-~ ' -
New, Alteration or
Address /C;-/I 124-A/t::j/;,U~!li) i) It-- '
City r:.fA~r/'/Vbi D~4me Lf31-<.fCj:20
- ' I
OIINER INSTALLATION
"
Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
37. Administrative Fee
TOTAL
3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION ,~Iowing project 85 submitled has the following
'~ '7 b C/ b rM 7za!ling, and does 'lPl reqq~s~~il:mt'fU-Single or
, aO'O',v.a" L-O,e..- Multi-Family per dwelling unit.
LEGAL DES~IjI'ION ""'b"''''' ~ningl ,':*,,-:::.:~.:L~: '
J7D~5/"17 '-'..,..,-,-,0' 0';101 "Items'
JOB DESCRIPTION Aufhorized Sign'81~re ~3~~. :;'ess ($ 85.00
...Lu--+-~r- ,I..f,-;a$k Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dwelling
Service or Feeder
The installation is being made on
property I ,own whiCh is not intended
for sale, lease or rent.
Own~jJ/~
__________L___~__~___~__________~----
DATE: .:Jl-t. NP 2-7 '20 d I
RECEIPT j!: /-I"ll i
RECEIVED BY: 1--- r<' ~
$ 35.00
$ 2.00
not included)
$ 40.00>
$ 40. 001 t:l :;a
$ 20.00,=:'2::
$ 36. O'GJ ':.' ~
CJ oc.......
~r;..j2~
GC--' ' I
. ......,..'...--.JO
rrl ::c ...0 (:)
~- Cj ".J 0-.
~i'Hf;,R5;3
,-"'~
........-
(