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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 1z o{>} HL]o trooa 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. sqloqlpc selnJ aql 0t00-I0&296 UVO u! iUol las alB ol no^ sallnbal MElu 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