HomeMy WebLinkAboutPermit Electrical 2001-12-24
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ELECTRlC.lERMlT APPLICATION
City Job Number 0 I - 0 I'll?" ( - 0 I
.J.
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
LEGAL DESCRIPTION
} 703 Z2( '3
Osl..fou
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
~~
~.-
~
3. COMPLETE FEE SCHEDULE BELOW
1. LOCATIONOFINSTAI.L~110N II .1/<;
5'2( MJ4-ald{L~ I'f Vc
Items Cost
Sum
JOB DJ;;SCRIPTION --, ' 1000 sq.ft. or less
IL/?C.Ol1 '^ ~-iA-- S~ <.(:1", Each additional 500
, -~ bmitled ~ tllCllql8'fflO%
Permits are non-transferable an'h~llittcwing prolec\ ~~:~~ecilic land use
if work is not started within 18lhda)oll. and doe. nO Each Manufd Home or
of issuance or if work is suspendlllP!ll~al ,11'1(2... '4edmar uwelllDg
180d ZOnlno.{/..r-. S' '...
ays. g.": 2 <f '--' L e~. t'__~cr
Date __
2. CONTRACTOR INSTALLATION ON! "'gnat"'. BrB" vicesor Feeders
A~\O~~' "
, lnstallallon, Alterations or
Electrical Contractor VL Relocation:
Address2175 l ,r;;.~k-
City~R Phon-;31/3-7:Jt)7
Supervisor License Number ~;;y)~
Expiration Date I () I (JI /61
I I
Constr Contr. Number-1:]:::J. C::;;::l
Expiration Date f);::J.,/fR' )6<,
Signature of Supervising Electrician
$106.00
$ 19.00
$ 50.00
200 amps or less
20 I amps to 400 amps
401 amps to 600 amps
60 I amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
--L $ 50.00 ,~
C. Temporary Services or Feeders
Installation, Alteration or Relocation
$50.00
$69.00
$100.00
Address ->2 ( J4I J1-(!An- (\ JI e
City~?~' Phone 7(j/~brbO
OWNER 'rNSTALLA TION
One Circuit
$43.00
Each Additional Circuit or with Service
or Feeder Permit
$ 3.00
The installation is being made on
property I own which ~s not intended
for sale, lease or rent.
E. Miscellaneous (Servicelfeeder not included)
-Each installation
Pump or irrigation $50.00
Sign/Outline Lightin~
Limited Energy/Res
Limited EnergylComm
TOTAL
$50.00
$25.00
$45.00
SD
-:3 r"-'_
/ L/ u-'"
157~
Owners SignalUre:
190:1:J3IHS\!::J
: 39N\iH::J
OS'LS $ l:O::J31:J lW\i
100l vl ::J30: 31\!O
~09LOOO-10:#SN\i1:J1
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee