HomeMy WebLinkAboutPermit Electrical 2001-12-28
IiZl 001
08/07/01 TUE 11: 33 FAX 541726.3689 CITY OF SPRINGFIELD
.Jhe fOlloWinliect as submitled has the following .J
225 FIFTH STREE-'zonl~g _ ana does not require specific land use ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, ORlWf.iINl97477 ff D1A /1.' \
INSPECTION REQUEST: '~n~il69 LD'~ (';~JobNllmbel~O\. rT:JJ...:.Ql
OFflCE: 726-3759 I;) _.;1$ 'D I
Date
]. LQCA 119P Of JN5.~Ai.lijI@lll",. . ~
~5W) 1if1Jt/1lJEN 4leltJ6-C A'tlt?-l>
,
2. CONTRACTOR INSTALLATION ONLY B: Services or Feeders
L L7 LJ A II 1 L .J;, InSllllIation. Alterations or
Electrical Contractor .1\, O):,tVnlfnJ. AI <:- Relocation:
. H. IJ '
Address CI tfl, if ~h~r-
CilS!RJA"pl7dtJPhone 1t/7.6t3J
Supervisor License Number /973;r
ExpirationDate 10/1 /~tJ(J'f.
Constr Contr. Number Ogt"qq
Idff/LJ~
(
LEGAL DESCJ3.IrTION
/702- I'ICYO
D6S-0(
~~ql
)
..JOB DESCRIPTION .'/
..J.jll5rtHl '7 ~ (!"'{/tr t'AbJ~.s
Permits are non-transferable and expire
if work is not Slaned within 180 days
of is.canoe or if work is suspended for
180 days.
EAl'iration Date
Signature of Supervising Electrician
.'. c.v,v;r';.c ,E FEE SCHEDULE BELOW
A. New Residential-Single or
Multi-Farnilyper dwellinguniL
Service lnc1nded:
1000 .q.ft. or less
Each additional 500
sq. It or portion
thereof'
Each Manufd Home or
Modular Dwclling
Service or Feeder
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Ovcr lOOO amps/volts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 31nps
Ovcr 40] to 600 amps
Over 600 amps or 1000 volts see
"B" abov"e.
~A~-
# -r. I. A . J A .1 D. Branch CircuiTS
Owners Name.i1V A . WElflTEJ() ~(/11 New Alteration or E:,:tension Per Pallet
Address .~5"O IIAtl1JEAI1J~/lJGC d
CitvJlI<IIICA4fJ;honc 7.;?b' ff(; i
OWNER INSTALLATION
The installation is being made on
property I own which is not .mended
for sale, kasc or Tent:
Owners Signature:
!90:~3IHS~8
: 39N~H8
S~'~9 $ 19aa8~lWW~
WOG 8Z 830:31~O
!V9l.000- 1:0: #SN~~l.
Items Cost
Sum
$106.00
$ 19.00
$ 50.00
$ 63. 00
$ 75.00
$125.00
$163.00
$375.00
S 50.00
S50.00
S69.00
S100.00
One Circuit
~ $4300 ;jj,~{)
Each Additional Circuit or with Se~'7 / "J tJO
or Feeder Pcrmit -+- S 3.00 ~'
E. Miscellaneous (Service/feeder not inchlded)
-Each instllilatioll
Pump or inigation
Sign/Outline Lightillg
Limited EnergylRes
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
Minimum Elec.tric Permit Inspection Fee is $45.00 + Surcharges
)5,00
~l' dJ.
r(;3 , ti? 5
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fce
TOTAL