HomeMy WebLinkAboutPermit Electrical 2003-04-10225FrcTIl STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726'3769
OFFICE: 726-3759
I. LOCATION OF TNSTALLATION
2466 Shady Lane
LEGAL DESCRIPTION
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JOB DESCRIPTION
Heat pump wit .jre ro[owing p roJect a
nd does not
if work is not started within 180 days Zoning
ELECTRICALPERMT DLICATION
City Job Number Cor^'".roca -O<U11
3. COMPLETE FEE SCHEDULE BELOW
A. New Residential-Single or
Multi-FamilY Per dwelling unit-
Service Included:
Items Cost Sum
of issuance or ifwork is suspendqd
I E0 days.
for
Permits are non-EansferaUte and,gi#d ::1 : i, rl:o hu St,$oTop,?[gon
req ur re specif idhefRgfise
1000 sq. ft.. or less
Each additional 500
$106.00 $
$19.00 $
Each Manufd Home or
or Feeder $s0.00 $
Installation, Atterations or
lrffrtrE:
*[mmm ;fifi th lir$ffi Y frBfss
400fifri,1eN 6@0h t s n gnNlroffiErrut$ r zs.oo
Over 1000 amps/volts S375.00
Reconnect Only $50.00
$
$
$
$
4^to
t,tirtorQed stgnature
2. CONTRACTORINSTALLATION ONLY
Electrical contractor JB ELECTRIC, lNC.
Address 4685 st.
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0t00-I0&296 UVO u!
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Expiration Date 't0t1t03 3114l04
Electrician
Dale
Address
Ciry Sprinqfield. OR 27477 Phone747-6547
-OWNER INSTALI.-A,TION
The installation is being made on
properfy I own which is not intended
for sale, lease or rent.
Owners Signature:
C. Temporary Services or Feeders
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
over6oo amps or looo volts t"il
B above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit I
Each Additional Circuit or with S"*i""-
or Feeder Permit I
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sigtt/Outline Lighting _
Limited EnerrylRes
Limited Enerry/Comm
5. SUBTOTALOF ABOVE ilrilHUil
7o/o State Surchage
l0% Administrative Fee
$4s.oo $
$
$
oa
$-
$-
$s0.00 s
$69.00 $ -
$100.00 $ -
$
$43.00 $ 43.00
$3.00 $ 3.00
46.00
$
$
$
$
$s0.00
$50.00
$2s.00
$45.00
3.22
4.60
$JB Job #TOTAL 53.82