HomeMy WebLinkAboutPermit Electrical 1999-9-28
.
S<<GFIELD
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. 5 submitted has the tollowing
The following prOject ~ uire speci1ic land use
zoning and does no req
ZZ5 FIFTH STREET 'lPJ1ro~al J"O 1"- E7..ECTRICAL PERHITAPPLICATION
SPRINGFIELD, OREGON 97417 Zoning- Oft;
INSPECTION REQUEST: 726-3769 q- -t.-B- 6ity Job Number ~9~"'?"'?'
OFFICE: 726-3759 Date , . rOd. ,; "
,Ml1lOfized Signature ::I. <.vMl'LETE FEE SCHEDULE BELOll
1. LOCATION OF INSTALLATION
C;/51-1111;Ilnl.l.f
LEGAL DESCRIPTION
;a. ..:>..2 -&tC-/": ~/.;;pt?
JOB DESCRIPTION
''-(1,,;/(11. /Illrqi"f - ~/1'I.lrd1(
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
. A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items'
1000 sQ.ft. or less
Each additional 500
sQ. ft or portion
thereof
Each Manuf'd Bome, or
Modular 'Dwelling
Service or Feeder
Z. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
f) .' Installation, Alterations
Electrical Contractor il//~!J,tI YI/II'~nt.# Relocation:
Address P. [). 6o",.l/()') G/ 'if ,ZOO amps or less
, 201 amps to 400 amps
City tf, 1.1 q In 1_ Phone L/<j, e/ - tJ I) 7'1 401 amps to 600 amps
, 601 amps to 1000 amps
Supervisor License Number ~~:ll J/...C" Over 1000 amps/volts
Reconnect Only
Expiration Date
/o/qq
Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00 '
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number 4'1.145
(\
Expiration Date '-1/00
ZOO amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
S 55.00
$ 80.00
volts see "B" above
er/ising Electrician
~
D.
Branch Circuits
Owners Name ;.In/hay I'lJiI<"fo'J1l'fi(J""
Add ress {J, (), /J;/) " 7:l, l/ I
City ?( f/9(r71 Phone I.tg'?-t.fJ~O
OllNER"INSTALLATION
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res --1--
Limited Energy/Comm
Owners Signature:
---------------------------------------
5,
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
DATE:
RECEIPT II:
RECEIVED BY:
q-~e'7-"?
._~~~
- 7Z .&"~/ r
r // '
$ 35.00
$ Z.OO,
not included)
$ 40.00
$ 40.00
$20.00
$ 36.00
'LO ' 00
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'l- Z-. no
'/0.00