HomeMy WebLinkAboutPermit Electrical 2001-11-16
feflWin9 projoct 81 submitted hes the tollowing .
'_ ' 6nd dOGS not require specific land use
225 FIFfH STREET ~PPf6V61. CtG E1,ECTRlCAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ZonlnQ I 101 ' _/
INSPECTION REQUEST:oZtJi-3769 , ~ II ,0/ $iI, :~t; lumber 0 1- 0/1 3 b -.........
OFFICE: 726-3759 . P\L-e,\J.Nl
Autnon.e<J Stgnature f. COMPLETE FEE SCHEDULE BELOW
I. LOCATION OF INSTALLATION
500 1/YlA-,/l/ s,-
#,,:,0"
.
LE~L DESCRIPTION
/ 0'3 ~<5' :; I
Oi!b,Lnl'?
JOB D1;:SCJUPTION
Wi(Lc rl-62..-r
C~LL&-(L7
Penn its 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 Cost
Swn
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$106.00 '_
$ 19.00
$ 50.00
2. CONTRACTOR INST ALLA TlON ONLY B. Services or Feeders
(I 5 ./ / Installation, Alterations or
Electrical Contractor ,~ f/t"t.'<<i/' ....) -;:rc- . Relocation: '
Address P (J CDX / yg-)
City5fr i')hdcl Phone 7 tj J ~ ?)3r';
Supervisor License Number I fa 1S 15
IQ-o!-a
,
200 amps or less I
20 I amps to 400 amps !
40 I amps to 600 amps '
60 I amps to 1000 amps
Over 1000 amps/volts I
Reconnect Only I
-.:L$63.00 252-
$ 75.00
I $125.00.LZ:S
$163.00
$375.00
$ 50,00
Expiration Date
- '--.., -IT 7'--C,-Temporary Services or'Feeders-'-
Constr Contr. Nwnber dO - I c.... Installation, Alteration or Relocation
Expiration Date
IO-OJ - ("2,
Signature of Supervising Electrician
Ql~ ~A _
uLers Nam.zm<:-<2-..a-ld /L + I-JSSOL.
Address SZ;; C> j/J'J AI /to' S I
Cit1l sP Fi~ Phone 7'17 - 7 (57/
OWNER INSTALLATION
The installation is being made on
Y' "Y";Y I own which is not intended
for sale, lease or rent.
Owners Signature:
----
200 am ps or less
20 I amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"B" above
$50.00
$69,00
$100.00
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
$43.00
Each Additional Circuit or with Service
or Feeder Permit ....:::1- $ 3.00 ~
E, Miscellaneous (Service/feeder not included)
-Each installation
Pwnp or irrigation
Sign/Outline LightiOl!
Limited Energy/Res
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
5, SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
3'18
Z7~
3/~
457 '7D
TOTAL