HomeMy WebLinkAboutPermit Electrical 2001-10-31The t_olra,,ving project as submitted has the tollowingzonir i does not require specific land use
225 FIFTH STREET APPTO'-
SPPJNGFIELD, OREGON 91 4}PNiNg
INSPECTION REQLIESETe
OFFICE:'726-3159 Authoraaed signature
I. LOCATION OF INSTALLATIONt372 t/. jo rh
LEGAL DESCRIPTION
ELEC'r ^ -vAL PERMIT APPLICATION
Number ,) I - O \z ll _C \
Lml
0
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SC}IEDIJLE BELOW
A. New Residential-Single or
Mdti-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
C. Temporary Sewices or Feeders
Installatioq Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 40I to 600 amps
Over 600 amps or 1000 volts see
"8" above
5. SUBTOTALOFABOVE
'7o/o State Surcharge
8% Administrative Fee
Items Cost Sum
$ 106.00
$ 19.00
s 50.00
$ 63.00 _
$ 75.00 _
s125.00 _
$163.00 _
$375.00 _
$ 50.00
$so.oo _
$69.00 _
$l00.oo _
JOB DESCRIPTION
insfa t( *curif't
Permits are non-transferable and expire
if work is not started within 180 days
ofissuance or ifwork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical corLtraaor -/!!!XrD Lgf u r t t y
Address '7
City Phone -l(b ffi,rJ?
Supervisor License Number /bSq t<Ef
Expiration Date tD- t- 03
Constr Contr. Number b5t4g
Expiratron Date
Srgnature of Supervising Electrician
Ou'ners Name
Address t32Z il.fh
{r ^ ' . .-1E--tg
AILATION
The installauon is being made on
propefty I own which is not inteoded
for sale, Iease or rent.
Orvners Signature:
D. Branch Circuits
ta / New Alteration or Efiension Per Panel
One Circuit $43.00 _
Each Additional Circuit or with Service
or Feeder Permit $ 3.00
E. Mscellaneous (Senrice/feeder not included)
-Each installation
Pump or irrigation $50.00
-
Sigr/Outiine Lighting $50.00
-
Limited Energy/Res $25.00
Limited Energy/Comm J-$45.00 W
Miuimum Electric Permit Inspection Fee is $45'00 * Surcharges
45',.',2,5
3.bo
iL75
k{.
j.n
utI
TOTAL
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