HomeMy WebLinkAboutPermit Electrical 2001-10-24
225 FIFTH STREET .
SPRlNGFIELD,OREGO .'477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELWICAL PERMIT APPLICATION
City Job Number n{- N03::t -of
3. COMPLETE FEE SCHEDULE BELOW
I. LOCA nON OF INSTALLATION _ L--.
3?.(p (V\~ ~ty~
LEGAL DESCRIPTION
ll.~.y;,.~l
k/t 00
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
. b 'ned ha,s~t))~ tollowlng
JOB !));SCRIPTlpN ^ The following prolect es su .011 i~6'\lIh(llj.l& or less
~01'1~ zonlng,:nd does not require spec,Each additional 500
Ol-'I-'".H '-. (J... Q..., SQ.J ft or pnrtinq
~ermits .are non-transfe:a~le and expirlo",~~ 1oz.4/ 0 I \ thereof .
.fwork IS not started W1thm l80aIa)'ll .. ~ J;ach Manuf'd Home or
of issuance cr if work is Sll"P""R&I/,K~ed Signature q<, .'>teduL L ",..::ing
180 days. Service or Feeder
$106.00
$ 19,00
$ 50.00
2. CONTRACTOR INST ALLA T10N ONLY B. Services or Feeders
n (\ _ D Installation, Alterations or
Electrical Contractor WA~ UJ (f'?(~ i 01') Relocation:
Address <P:Plct fllll Dtu, L-cun e 200 amps or less
( 20 I amps to 400 amps
Phone Gl Pi a- 0<1 05 401 amps to 600 amps
60 I amps to 1000 amps
Supervisor License Number I 5 (; A '3 Over 1000 amps/volts
P.T, -::~"I'iOi",: \,'1f'r : .... ;" , Reconnect Only.,
~xpiration;Date. ,I t\ \ \ \ D.,
fl'" ....i-.n C -'I . , .
i,.~.~tr. Number :S,44?:> I
Q~~~ir:~~r~ie:: ~'q I ~n io ~
nuwber.;~. . j:. "'~ ....'. ,
Signaturc'ofSupervising Electrician
City}:' J c.~o,^~
I
$ 63.00
$ 75.00
$125.00
$163.00
$375,00
$ 50,00
~~~
Owners Name Me-tco I V\ OOfYV1Ul;fs
C. Temporary ServiCl.'S or Feedm.LL EXPIRE IF THE WORK
1nstaIlation~ Alteration or Rfl.ffi"di1'~ HIS PERMIT IS NOT
200 amps or less '. ; .1R IS ABANDO~~:::D$3~!Oo _
201 IUJIps to 400 ~mp's':;::C'!:', $69.00
Over 401 to 600 amps $100.00
Over 600 amps or 1000 volts see
"8" above
D, Branch Circuits
New, Alteration or Extension Per Panel
Address 440 t;:. ~ YDo...~ *[ t> b
CiN E::lA~ Phone
OWNER INSTALLATION
One Circuit
.-L $43.00 L3 00
Each Additional Circuit or with Servij:f '21 ~
or Feeder Permit ~ $ 3,00 _
Owners Signature:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lightin2
Limited Energy/Res
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
The installation is being made on
property I own which is not intended
fur sale, lease or rent
TOTAL
iO.ro
l{,90
5.bO
~O,SD
no : ~3IHS\J::1
: 39Nl:JHJ
Og'OB $ 2:Q83~ lWl:J
1002 iJG 180:31l:JQ
L90LOOO-10:#SNl:J~1
*
5. SUBTOTAL OF ABOVE
7% State Surcharge
11"10 Administrative Fee