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HomeMy WebLinkAboutPermit Electrical 2001-1-18 . . SPRINGFIELD 65 01 . oJ .60 225 FIFTH SiltJJGE: SPRINGFIELDr€8 ,7059 (54tj';l;!" !J FAX (541) 726.3689 ~tEe'l.'R.ICAL PERMIT APPUCATION ;.Ii" ~'t::..j;:'AJE,: r ~:':'n'vJCE;J LlL.:tr.fieift/Htsw'rrlg lonlng and d~,:~e~~~s SU~mitted has rhe fOllow; approval. reqUIre specific land use Zoning C!..c- Dat. /- ('0 -0 ( 97477 726_)1g~izeo Signelure Q{..J 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. LOCATION 9i) INSTALLATION S C::v '" ~"'/'('.J- ;-VI LEGAL D~SCRIPTION --? I TO d.;) OGG - ~ <ll JOB DESCRIPTION )',. C (j I2;,Z7 ~y ) 4..., Permits are non-transferable and expire if york is not started yithin 180 days of issuance or if york is suspended for 180 days, 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor ADT Security Services Address 4660 Main Street. B1d~ A. #100 City Sorin~field Phone 736-4973 Supervisor License Number 853 JLE Expirat'ion Date 10/01102 Constr Contr, Number 26209CLE Expiration Date 10/01/01 Signature of Supervising Electrician /J'1L-.,~ 4- Oyners Name Co '" ~ r......( ~z,j.j /4"L/l' ~ Address fnn;- ,/77 ~tZ Q I.. City Phone OWNER INSTALLATION The installation is being made on property 'I oyn yhich is not intended for sale, lease or rent. Owners Signature: DATE: l- \ I{ - 00 RECEIPT 11: L{2'f:5 RECEIVED BY: \ ~ .b---- "1,.,1000 sq. ft. or less "'Eal::!1fadditional 500 THiS.sg"t ft .or portion >-_" Ifl/-r- $ AI'~ ,.t,~ereof.HALl El(PIP ._ .- fEach?IMJlt!NJ";,!I,,!!.omeforTHEWOR' c...,. 'iiliModular Dyellii1gpr-R" K -. 'VC'" )~"~ <:c, IVlITtSN ",_ Y 18Service 'or.}FeederN 0"'$ ULJAYPERlOD -. "'o.JU Eut-OR B. Services or Feeders Installation, Alterations or Relocation: City Job Number 3. COMPLETE FEE SCHEDULE BELOII A. New Residential-Single or Multi-Family per dyelling Service Included: OI-065Q6- 01 Items unit. ~ cos~m S 85.00 15.00 40.00 200 amps or less S 50.00 201 amps to 400 amps S 60.00 401 amps to 600 amps S100.00 601 amps to 1000 amps, ..,'r "OL'S,pO.OO Over 1000 amps/vol rS~)r-i .ro~'f 't.$300. 00 Reconnec t Only' '" "8< .". . '" ISt)40. 00 . ..'I"iiILJUQIiO .-...... ~di;'iO(.h '''.,.. .. I A!:"1'oi"""..... Temporary Servicesl or, .Feeaersit_ Installation, Altera ti8f}rob~Reloca tion ". ",.; ld/GPhone -J 200 amps or less qjfl"otificatio,$ 40.00 201 amps to 400 amps -,' i. $ 55.00 Over 401 to 600 amps S 80.00 Over 600 amps or 1000 volts see "B" above C. Branch Circuits New, Alteration or Extension Per Panel $ 35.00 One Circuit Each Additional Circuit or with Service or Feeder Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 2.00 not included) I I S 40.00 $ 40.00 $ 20.00 S 36.00 'Y.; . oQ... '~r.~ ?,Ct .f>O