HomeMy WebLinkAboutPermit Electrical 2004-5-19
225 FIFTH STREET
SPRINGFTELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
.
ELEaCAL PERMIT APPLICATION
City Joh Numher (o#1ZOOll_ 00 z..b f'
3. COtvlPLETE FEE SCHEDULE BELOW
A, New Residential-Single or ~"
Mul!i-Famil)' ]ler dwelling unit. . " " "
LEGAL DESCRIPTION b' {I ",ln9 Service Included: ' '
17D2-3.S'3'-f O~ J (\1\"sll\el~l~se Items COSl Stml
sl.l\){f\\\\9 c\\\c \a(\
" ae\ as 'fa s-pe
JOB DESCRIPTIO;''t~~'O\ nol le<lU'{\ 1\ \ ~ sq.fl. or less
'i:S C I I. - oes r-" ~ EaJjJ' ddilionaI 500
iO"'" .---<- '\ V
\>\>10",,1, 'n ____ -/..-", " sq. ft or portion
Permits are nou-Iransrerable alM>\!~~re D eof
if work is not started withiu 180 Each Mauufd Home or
of issuance or if work i,Qj\\~pend:Jl4\ljl1"IU(e Modular Dwelling
180 days, I'UII\Ol\t Service or Feeder
I. LOC<\. TION OF INST ALJ.A TION
709 S- 1A4;'orl /II ~'1'
$106.00
$ 19.00
$ 50.00
2. CONTRACTOR INSTALLATION ONLY
E
B. Scn'iccs or Feeders
Installation, Alterations or
Relocation:
Burrell Bros. Electric
J 40159 Booth Kelly Road
( Sprin_g~i~~~ Oregon 9~4=-J
Supervisor Liceuse Number ~~~ _~
Expiration Date
,~\c'-'>.
200 amps or less
20 I amps to 400 amps
40 I amps 10 600 amps
60 I amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375,00
$ 50.00
Expirmion Date~\.....~
'\. .
C. Te!j.'l\lljJ1,ry Services ur Feeders
~jQst,\mltmn\ AlI~rtEt~L11li9\1\E WORK
1HIS PERM 1 ~11 PERMIT IS NOT
AU1Hmllam\}sIJNlJ~R lH~~DONED f-OO- $50.00 _
COMwAAW@telW\&~~S' _ $69.00 _
. NY l\la\1~tflt.IJUOOps $100,00
A Over '6oii amps or 1000 volls see
!tBll nbove
" Constr Contr. Number&.=- ,,-,u.,'"'l ('
Signature of SUJlcn'ising Electrician
~.~~;.k~~~
D. Branch Circuits
New Alteration or Extension Per Panel
Address:PO ~() X
City Ec.AG-<::;V(2 Phone
ZZ.bb
One Circuit
r $4300 if ~
Owners Signature:
-;. - . :. ')reS8mt 1i\\l!lmS\\!l~rYm,l ~with Service Z I
. ,.', .loph1d<~M1ql.Q,llQon-()tmtV 2 $ 3.00
,'..1 _ Jnter. Those rules aro sst for!)\) -
,~)_~:OI,\Ij,>@~O,tiw<llllg5cGAa9~Bt included)
, 'I~J may obtalFfls~jlistilUlfttm& NIl'\) bV
, ;(' the centeP'll~ei_~phons
1:"'i~'\I;~r lor the O~~~J~~1lcn
Center is t1tID.b'..;:)J.t:~.-.4~~
ll1uted Energy/Comm
$50,00
$50.00
$25.00
$45.00
OWNER INSTALLATION
The installation is being made on
property I own which is nut intended
for sale, lease or rent.
i\Iinimum Electric Permit Inspection Fec is $45.00 + Surcharges
TOTAL
bl{
4l{8'
b40
?{ !?i?-
4. SUBTOTAL OF ABOVE
70/0 State Surcharge
80/0 Administrative Fcc