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HomeMy WebLinkAboutPermit Electrical 2001-6-1 ; '\ ,I I I i , , .. ! 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST,: 726-3769 OFFICE: 726-3759, 1. LOC4TION OF INSTALLATION (;,4-0/ />>A-/V :iT: ~~~ \,0, ~. LEGAL DESCRIPTION J702~~ 4:> ~(!Jfn/)/) JOBpESCRIPTION :J?1, C/. ~J.) MJU1 L." 7'"" f Permits are non-transferable and expire if york is not started vithin 180 days of issuance or if york is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLYB. Electrical Contractor ~~ ~ Address /CJ~z. ~ ,j; 0 - , City f(~ Phone 7,;1.9-/500 ? Supervlsor License Number ~~~-~ Expiration Date /l/ o( Constr Contr. Number b?-/~7 iSJ;~.. L/ /5/ Or- f I Signature of Supervisin~ Electrician '_'.;i~~~ ,Ovners Name AkC...e:: ,/049;- Address t::, 4' tJ / ~A-?A) City S~.I"7) Phone~';" 7S~2.- , . - Expiration Date OIINER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease'or rent. mo: ~3IHS\i8 : 39N\iH8 Ovners Signature: OO'S $ ~ OO'OB $ 7:rT'1:N IIJH ~~~~0~5-i~~~i(a~~------------------------------ r"""c.Hl ff: RECEIVED BY: ELECTRICAL PERMIT APPLICATION City Job Number OO-O/Sj./-O/ , 1'\ COMPLETE FEE SCHEDULE BELOII ~r Nev Residential-Single or, Multi-Family perdvelling uni t., " Service Included: ' 3. , A. Items Cost Su 1000 sq. ft. or less, $ 85.00 Each additional 500 sq. ~t or portion thereof $ 15.00 Each Hanuf'd Home,or Hodular'Ovelling Service or Feeder -z., $ 40.00 1:Q. 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 ampsfvolts Reconnect'Only C. $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less 201 amps to 400 amps Over ;01 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits $ 40.00 $ 55.00 - $ 80.00 - see "B" above " Nev, Alteration or Extension Per Panel Hiscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit Each Additional Circuit or vith Service or Feeder Permit E. 5. SYBTOTAL OF ABOVE 7l7. State Surcharge 3Y. Administrative Fee TOTAL $ 35.00 $ 2.00 not include, $ 40.00 $ 40.00 $ 20.00 $ 36.00 M.O-O c;:~o 2-.1'0 ~ Q. era .'--"''--' , , -. - '. . ~. I .. 'I ',. '\ :1.' 1 , . , . . . 't', I , " .: r:. .' ,.' .- TRANS#:01-0005608 DATE:NAY 31 2001 ANT RECD:2 $ 80.00 2 $ 8.00 CHANGE: CASHIER: 003