HomeMy WebLinkAboutPermit Electrical 2001-5-25
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TRANS#:01-0005537
- 101
70
CHANGE:
CASHIER: 011
ELECTRICAL PERMIT APPLICATION
City Job NumberJlI 1J();).c,<.j. 01
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1tJl--1v'-~<, 00 W 0\
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION \ \
Klv WI A-r\S J=',e..- c\
LEGAL DESCRIPTIOp 0
/70;3 d- ~~'-/' S'S-OO
,~.~~D~~~~ ~ ~ &~M~
. Permi ts 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 B.
Electrical Contractor {J ~i \ '5 Lle.:UVl-
Address 10' AN )5'/0'/
ATTfCHiOj\I:0regnn ':1W rcv"'''~''d "QY ru
Ci ty..!1;-"/~,^.~W\.<tbvtBho-negc;~IUJ::>;-? \:) )
I\,~;ii~~tian r.f'blter. Those rulas are',"lc"8"rt", L
Supervisor, License t'Number)AR! 5iH,G -<J
. OAR ~::>GA)U I-VV IV ..,......:;1..
I~r, nn \1"" m"Y obtain (/c~ie.s. at t)1e Ole,s ty
Exp~'ratlon Da te.__ "f~l:?. the. ,,,,,,t,,,;) Ie
calling the cen>-=v - ., f n C
C "i'fll"," '''t. ..th6N"'''''boon UtilitYi'oJRilY'fl\lQl f - 1-\ .
onslt;;r \Jon r. urn er. ",,-,n "hAW, Lf 'IS' UG
Center is l-tlul- --- - ..
Expiration Date 1- 0,)
Si~ature of Supervising Electrician
lJ~ k/~
Owners Name l..A{LVl YD relf\.
Address ~(U MA-I\:} ('..e\~
City~~foW. Phone
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------7------r----------------------
DATE: ~ ZGI.D
RECEIPT' fI': - c;,~}J ,-I
RECEIVED BY: ~(r'
COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single. or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq. ft . or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401t.~IIJq~C11!>; 600 amps $100.00
601 amps _tollQ..OOAl~"\!'~'Cl~ Iqf~13/])~9
OveifbtOOQ.P~~pSirv(jl'ts ' S3Q,Q"QQ
Reconll(l.C'tRRn:1YUNDER Tl'1'" rcnM~-hO'~'dO
1'\u II IV __-t
~""''''''t'~En OR IS ABANDONED FOR
Tempolia,r.y- Ser'trces or Feeders
Inst,i(M'It:ltoJ!',Ytlin'~.tion or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see uB" above
D_
Branch Circuits
New, Alteration or
Extension Per Panel /'
$ 35.00 j'S
J-.
J
One Circuit
Each Additional
Circuit or with service"
or Feeder Permit .
$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 31.00
5% State Surcharge 'Z''Cr'1
3% Administrative Fee ~.ll
TOTAL 4-b; IV