HomeMy WebLinkAboutPermit Electrical 2004-3-2
, '225 FIFTH STREET:'. ~ f" ,!" ~'.' roo f ,. ELE.CAL PEAA-nT APPLICATION
: : ". ,SfRINGFrELD.QREGON974771,:JI : ,,Ji i l.. \ :" '-
. '.: ,[NS~ECTlqNREQUF~T:726,3~69,J;. L,:, '1' 'Ci'tyJobNlimherCO,"Z<ro4-0004~
'. I 'o..~F\CE: 72~-3759, ~ \ .: I : . oj l' : i I {!; f .
',,: ' ',' ',r'."2>\\.A.'b,\Cl.LLl~K:. r.: 3. COMPLETE FEE SCHEDULE BELOW . ~
"I 'L LOCATH)NOF~STALLATION i' :: ;:. j I',
\., ~,'.., 01. cffiA\Yi ....;5f:J ,,} "J ',-, 'A. New Residential-Single or -----'- - .---.-
Multi-Famil)' per dwelling unit.
LEGAL DESCRIPTION Sen'icc InclUllcd'
/703.3 c:;'-{ L oo/<ye Items Cost Sum.'
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JOB DESCRIPTION "submitted has ttJAlllbwir/ll. or less
C~ ') IW1 \l -;:,~c;."";'3'~.,~:':~uire specific lillltllWditiona1500
~e. ~f~i~al. sq. ft or portion .
Permits arc non-transferabft and exnire g (l (1. Il.....f
: f:onln - '
if work is not started within 180 days "3' ;2.-04 Each Ild;lll.ufd Home or
of issuance hI' if work is sugpetld,,~ ,", ~0 Modular D'.velling
180 days. . \ hjjlillillL.~() Signature "erVlce or Feeder
$106.00
$ 19.00
,<
$ 50.00
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2. CONTRACTOR INST ALLA TION ONLY B. Scr"iecs or Feeders
:. ; ", . . Installation, Alterations or
Electrical' Contractor me-rrc-~~,,) s:s(\ ~ ~"'j Relocation: /
Address ~~:' J. 51:!!L "0\. *,.{S"-.,
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Cit)'~~~\-jit:l:t> Phone ]U'1o.3'<:>1,).
k supervis.~i Lice.n~,c' Numb~r 5.5f(,5 i 4 .
U Expiratibn Date U ItJ - 0 4
f/'-.;"~ . '.- .
""Constr.l;:ontr. Number I;) "3 :''2, (p
/ .'
200 amps or less
',- 20 I amps to 400 amps
, , 401 amps to,600 ..nips
, "60 I amps to 1000 amps
O\;er 100D amps/vollS
, I
Reconnect Only
$ 63.00'
, --'- $ 75.00
$125,00
$163.00
$375,00
~ $ 50.00
C. Tcmporar,Y Scn'i.ces or Feeders
. Installa~ion, Alteration or Relocation
'.,. EXPiration~:- '--4 ~ t,'O . OlD .N9ili\jf,~ ~r.,l~AlL E,XPlf\Elfl\-\E WOO~O ~'
. . . .. .--.::.: _~ __. 'lia~ ~Will ~ .'1Pi"R 1\-\15 PERMll!.~~~O --'-
~ulcrmll1g Elcctnc ' - ---AQ\f<\1!@ti\Uli.eo \1'1\i r.RANDONEUf.O~OO.oo ----.:
, '. ' C9.\m-.~\:iWfUttP1 Qf\ '''lllls see
, , : .~. ." AN'f\'B~ DAY PERIOD,-"", ,
D. BI~allch Circuhs
New 'Alter~tiou or Extension Pc/Panel
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OWl;ers Name "")'" \ ~~f\l:'..
',( '1 ~I()l,
Address .+2 -: r,,~ . ',~~
Plcce<\(JL. ICe., '1:l '13Q,
Cit)'-<<l."'f" lr.n: Phone "''II, '\'11, ~'1~1p
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One Circuit
,
$43.00
Each Additional Circuit or with Service
or Feeder Permit $ 3.00
OWNER INSTALLATION' . n iaw reqUireS you to .
The installation is being made on ^JTENTION.'E'.rf'NiRcellaneoi!s, (Scl;vicClf tied")' not included)
,.., d t aD\lUIt:l-I...~v.. - 1
Property I own which is not II1tendedfollow rules a op e -Each inst:lIl"Uonet torI'
. Thc~e rUlt1::t PI":'''' _
for sale. lease or rent , 'IIotitication Center. t~~,';P,8r '{9.&~~~52-00 _ $)0.00 _
, n OAR 952-001-0010 SI!lrll'0tnlll1etLigltUnlLs \ ~ $50.00 .iJ2!? eo
. . Cn"l'''!;...01 n, """, -
Owners S,gnature: . . 0090 You may obtalOl3ltnll.cI'tner&\~esone $hOO
. (' '._..~. -1o.<>~' B" $ - 0
'11'n9 the center. l'Jl\lllted't;ner \' ommon _ 4).0
ca : ,_ r the Oregon Utility 0 \TIcal! -
IIUI\"JV';~",",.i'linimUrilrElecfI;2;p~Ahit Inspection Fcc is 545.00 + Surcharges
4. SUBTOTAL OF ABOVE
7% Slate Surcharge
8lYo Administrative Fec
I-'SO.cO
10. SO
l;:;.Ob
l '1 J , 60
TOTAL
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