HomeMy WebLinkAboutPermit Electrical 2001-12-31 (2)
.
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELEC& PERMIT APPLICATION
City Job Number 0 r - Dr L/ 3 F -01
3. COIv1PLETE FEE SCHEDULE BELOW
1. LOCATION OF INSTALLATIO~.... .A. IE
371)0 {bmffJffClO/ sft'~vc..
A. New Residential-Single or
Multi-Family per dwelling unit.
Se~~~ncluded:
'0\\0
\~0 \ I)S0
~~s \~~o
00 .~w
JOB :pESCRIPTION _ lJ.'Oi-\~ s~0C;ruOO sq.ft. ess
Inc::;-!a(! SeclI....nfy 'C\~ss0o.~\~0 Eac . tionaf"5 00
~O\V 0\ ~ ft 7- -
. (\~ Q S (\, . or ,I. L.on
. . >1'1' 000 f
Penmts are non-transferable and e~ '3-(\0 0
if work is not started within 180 'a<aJS"'c;, -1'3-\ . (\~ ,.() \ ac ufd Home or
of issuance or if work is suspendedJG>:r') 1.0(\\ ~ 4:2\ aular Dwelling
180 days. ~\\l\e Service or Feeder
- \~(\
~'3-\e 0'::>
2. CONTRACTORINSTALLATIO O~y1.e B. Services or Feeders
C" _ ~ P' _ Installation, Alterations or
Electrical Contractor u:::>nr in; / 5?L.unfy Relocation:
Address '74g- Gnzda7$ brf Is. R:i 200 amps or less
v 201 amps to 400 amps
City ~jn,e-tJj1 Phone 40/-5078 401 amps to 600 amps
U 601 amps to 1000 amps
Supervisor License Number / (089 I< ET Over 1000 ampslvolts
Reconnect Only
LEGAL DESCR.1.t' 110N
/707- 3/( 7.
00700
Items Cost
Sum
Expiration Date
ID- l-tJ 2-
Constr Contr. Number to .'514 9
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
lo-z>t--()4
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"B" above
Signature of Supervising Electrician
~~~-
. D. Branch Circuits
Owners NameJiiL/Shol'l) F'lJresf Pnduc-t-S New Alteration or Extension Per Panel
Address 31o/)() ColJ1merd'a/ sf.
City .<::;l?rt'ngPif !d.Phone 73fn -5050
OW'1rER INSTALLATION
One Circuit
Each Additional Circuit or with Service
or Feeder Permit
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm I
Owners Signature:
T.90=~3IH8t1:J
= 39NtlH:J
SL'TS $ l:O:J3~ lWtI
100l 1~ :J30=31tJO
9~9LOOO-I0:#8NtI~1
$106.00
$ 19.00
$ 50.00
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
$50.00
$69.00
$100.00
$43.00
$ 3.00
$50.00
$50.00
$25.00
$45.00 46pZ)
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
45170
3/5
3.6:>D
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