HomeMy WebLinkAboutPermit Electrical 2001-9-24 (2)
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01- (Pl/, '
225 FIFTH STREET The following prOjeC.bmitted has the fo~TRICAL PERMIT .CATlON
SPRINGFIELD, OREOOlih@741ila does not require specific land use I I
INSPECTION REQu~.t1OY!6-3769 I oc City Job Number 01- 0 f 0 , .. -,0 I
OFFICE: 726-3759 Zoning..... , ,
Date q ~DI 1 rnMPT PTE FEE SCHEDULE BELOW
1. LOCATIONgFIN~TAIiT. LATION t' '''''PI~
/ G lJ ~uthonzeCl "STgna ure -1)'\.{.
_ IlP -, . D7TiJ N l.VooD A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
~J-fja.)
JOB DE~RIPJ:h
+\ .P: .' FAt..
11, 03 -1.1.:;~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days,
2, CONTRACTOR INSTALLATION ONLY
Electrical Contractor JB ELECTRIC. INC.
Address 4065 W 11 tho #18
City Euaene. OR 97402 Phone 541.687.5770,
Supervisor License Number 3872S
Expiration Date 10/1/01
7(00
Items
1000 sq, ft.. or less
Each additional 500
sq, ft or portion
thereof
Each Manuf'd 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
Constr Contr, Number 37587C
CCB C, Temporary Services or Feeders
104929,
Expiration Date
1011/01
3/14/04 ,
Signature of Supervising Electrician
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Owners Name '~ol\lAJ;-e "5 VV'; "(Ii
Address J (p C'j t) unto 1J woo 0
City Sorinafield. OR Phone '? l./.7-1I7 t.f..
OWNER INSTALLATION cnq.77
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
zm: 1~::llH::itj:J
:39NUH8
gg'08~~.:.aQ~rlWUf7r11
lOOG " ~100 ~ '1
I~L90 0-10:#SNU~1
q-(~-O r
t<w
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
B above
D. Branch Circuits
New, Alteration or Extension Per Panel
I
One Circuit
Each Additional Circuit or with Service
or Feeder P,"H1~~ 7 _
E, Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited Energy/Comm
5, SUBTOTALOFABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
Cost
Sum
$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
if)
Lt
$3.00
$50,00
$50.00
$25,00
$45,00
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