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HomeMy WebLinkAboutPermit Electrical 2001-7-26 -e e. 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726.3689 PERMIT APPLICATION The following projeet as sub~has the follow zoning, andW \rryqut~ sveCific land use approval. 0 nL-O 225 FIFTH STREET ZO in t'. 1>T~CAL SPRINGFIELD, OREGON 974770al.a ~I OJ INSPECTION REQUEST: 726-J/b':i '1\Pl~ City Job Number (')(-0039'7 -0/ OFFICE: 726-3759 Authorizad Signature I ~'-. 3. COMPLETE FEE SCHEDULE BELOII 1. LOCATION OF INSTALLATION ( '2, &J'i? tlA-t00u RI2tIJ6r=- ~~ A. LEGAL DESCRIPTION J7d2... 1900 6J'JOD JOB DESCRIPTION . 'Tel?'1~ Se~vtt:..e Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor L. f(, fJlO1CtIt1;. etEcr Address 4fJ-> SHeu./S-r 41 . Ci ty {,I'Pb Phone i 4 ') - (:I f'1 ( Supervisor License Number <3 O"Db' So Expiration Date 10 - {- O( Constr Contr. Number O'~l<;(- Expiration Date (" (-01 Signature of Supervising Electrician ~___12" ~ ~ V' r Owers Name ~\ ~ ?--, Address~ \3. '-----\.~'" ~~ Ci ty ~ AC.<;::.J'o-...\E'- .' Phone OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -------------------------------------~ DATE: Df I ~O( I I r,,t' RECEIPT 11: h\ \ vI RECEIVED BY; I\ vr New Residential-Single or Multi-Family per dwelling Service Included: unit. Items Cost 1000 sq. ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular O'Jelling Service or Feeder $ 40.00 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 Sum $ 50.00 $ 60.00 $100.00 . $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps ,Over 401 to 600 amps Over 600 amps or 100Q D. Branch Circuits $ 40.00 40ClJoL $ 55.00 $ 80.00 volts see "B" above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm CIne Circuit E'ach Additional Circuit or with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 not included) $ 40.00:",. $ 40.0~=;:: $ 20.00;0 ~~ $ 36.0a;J ':..'.~ C':l o~.. D ..co 4~CJ r f-" - - I ~~<>>>~g l?~~"CJ~ 44!~:",Q~ j--.I."O!-lt.n