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HomeMy WebLinkAboutPermit Electrical 2001-3-6 o ~ . e,"lau6!S peZ!JOuln\l DATE:M~R 06 2021 \ J ~_V) ;. <r: elaa . AMT. RECD.2 $ 47,..J9 . . :U1UOZ CHANGE, /} J c..rr QJf '.. CASHIER: 003 (/ la~OJdjj~ "CTRICAL PERMIT APPLICATION :G" PUBI omoeds 9J!nbeJ 10U seop pua 6ulu'dt-L . 97 It QlIOI.8ul sau pell!wqns SB peloJd 6ulMOIIOleul' /. I . i'l. -J/b9 City Job Number~ -D~23 -C) _ 3. COMPLETE FEE SCHEDULE BELOII . 225 FIITH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. LOCATION PL INSTALLATION J? <1' S !IL=l!f /) /""-J 7S () ~ :f~ A. LEGAL DESCRIPTION !7.n3 ~ /2- 6.A'lPo . ,J'pB DESCRIPT]ON. ~ W r~ ./JAm <()-'" [.;l. cd) Lt'(/'frS' 7 n~s- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. . The installation is being made on property I own which is not intended for sale, lease or rent. . Ovners Signature: --------------------------------------- DATE: RECEIPT #: RECEIVED BY: New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cos t Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home. or Modular .Dwelling Ser~ice or Feeder ,$ 40.00 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL 2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders 'I, , Installation, Alterations Electrical Contractor_~S ~/c>crtlc1~~~.or Relocation: Address a. L) . 'ReX. ) <,/y? '3 200 amps or less ~' . / (. 201 amps to 400 amps Ci ty" . '.~A::;-_ Phone ",fb -&2 '?G 401 amps to. 600 amps ~u' 601 amps to 1000 amps Supervisor License Number 3 V97 SOver 1000 amps/volts / Reconnect Only Expiration Date 10/1/0 I I Constr Contr. Number 7 {) rfR9 I Expiration Date );L/:;olo V / . s~ature OJ Supervising Electrician ~/_<>.) !/ ~j~ owner~~_&h .e..L-~tJoo Address f1S' ~Ob>-L- (JJU~ Ci ty ff (./0 Phone ?V7'-/S'"7Y OIlNER INSTALLATION $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"oT less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Circuits volts $ 40.00 $ 55.00 $ 80.00 see "Bll above " New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit I ?5:oP $ 35.00 ~ ~.- $ 2.00 not included) E. 'Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 40.00 40.00 20.00. 36.00 $ $ $ $ A..?C'O 7j:b-1 1"2 r j --- :;c Tit