HomeMy WebLinkAboutPermit Electrical 1999-7-26
Authorized Signaturp
225 FIFTH STREET . NOTICE' ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477' . a.,
INSPECTION REQUEST: 726-37#lISPERMITSHALLEXPIREIFTHEifi9RYub Number ('107 16
OFFICE: 726-3759 AUTHORIZEDUNDEBTHI~~ITISNOT
3. O. TE...FEE SCHEDULE BELOll
L LO~ION OF INSTALLATI060MMENCEDORISABAN II-Uti
h6 /111,4./.,/' ~~IY1AnnAYPERIOE).. New Residential-Single or
, Multi-Family per dwelling uni t.
Service Included:
Electrical Contractor.Q,,lc; V'IC::/JJ
n . /
Address /"'. O.8a~ 7o.;i'J'~ 200 amps or less d- $ 50.00 ~4?
. 201 amps to 400 amps ~ $ 60.00 htf/4JV
Phone id' .?-/<4'ii:~1\")1.,,}01 amps to. 600 amps $100.00 '
lollow rUles a' Wl~' amps' "t,o It 100g _ a~ps $130.00
Supervisor License Number Z / 9 4iQ.5fjr.~tion Ce~~Ovff?'1000Ja!l!R.~(~RJ,f/s $300.00
in OAR 952-00 Reconnec~eg!l;J.rsel/ort', $ 40.00
Expiration Date j 0 ~ dL=....n / OO~ 1-0010 Ihrough OAR 952 .
cal/' u may 01:1t.elhPOI1.l!!'~os.e~vlcfsI)16r Feeders
Constr Contr. Number LA..~" Al nl._~ng the CenrllnSl~ijkia.tior\~ ~it>t"e'r'a t ion or Re10ca t ion
r - ..to:. forthe OreQon' U ,'.,': ""t" P"one
~ Co. I Iry NOIJfir':>li .
Expiration Date .e=:., -/."r- d/ enteris20Qca,lpllcli:,<?I4)J:esson' $ 40.00
. 201 amps'to 400 amps $ 55.00
. Signature of Supervising Electrician Over 401 to 600 amps $ 80.00
r?~ t'U?~~ Over 600 amps or 1000 volts see "B" above
..r ----::r~ /J II I I D. Branch Circui ts "
Owers Name 50 (o! ril'-h{(~ $CNlJ
New, Alteration' or Extension Per Panel
Address S;2.~ Mt II y/
<:; -f) t I "i Phone 7 l{ l{; t, 17\
Date
(' .(L/
.., ~J-.(rC1 "'i ,
~
LEGAL DESCRIPTION
/7/)335"11 /0100
JOB,. DESCRIPTION
f(alhl(Jde.~ l:Vr-l-., ,eJ.d9
/ I
Permits are non-transferable and expire
if york is not started within 180.days
of issuance or if work is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
.B.
.et.od
City. Sof-d
City
OllNER INSTALLATION
The installation is being made on .
property I own which is not intended
for' sale, lease or rent.
Owners Signature:
DATE~------------------~~-7-T2,;tfY----
RECEIPT #: " 7<1 H 7... . /~) .II
RECEIVED BY: ~
Items
Cost
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuftd' Home,or
Modular. 'Dwelling
Service or 'Feeder.
S 85,00
$ 15.00
. $ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
One Circuit
Each Additional
Circuit or with Service
or Feeder PermH
$ 35.00
(rL
$ 2.00 ;;::Zci>O
E.
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40,00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
SUBTOTAL OF ABOVE ~d> 'CJ
1'1oSta te Surcharge I ?,t:. t'-
37. Administrative Fee . /.5~
;;N! 7 :J- C>
IO/~ F :/-77.?C?
s.
TOTAL