HomeMy WebLinkAboutPermit Electrical 2001-4-12
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-
The following prolecles submitted hes the following
, d does nol require specific land use
ZOOlRg \ an
approval. ~
- Zoning
9;I,!J.77 ~~ /~~O 'I
'1'2'&-3i69 . WJ
.. ALJthorized Signature
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
/7023:'332
6 ""0 z.
JOB DESCRIPTION
St:(\J~'~ f'l("~ -
Permits are non-transferable and expire
if work is not started within 180 days
of issuance ~r if work is suspended for
180 days. '
ELECTRICAL PERMIT APPLICATION
~ity Job Number 0 I - 0035'8 - 0 I
3.
COMPLETE FEE SCHEDULE BELOI/ .
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
A.
Items
Sum
Cost
1000 sQ.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular 'Dwelling
Service or Feeder
$ 85.00
$ 15,00
. $ 40.00
B. Services'or Feeders
~~ Installation, Alterations
~/>I"M.sor Relocation:
2_ CONTRACTOR INSTALLATION ONLY
Electrical Contractor '/):1ne ~r,~
. ,:
Address 2 ~2 r f I uev-vlet--l Sf
Ci ty E0~~ Phone i~,i) loN'cn\l
Supervisor License Number 'Ztl.\\:)l.f:-
Expiration Date (6/01/0"2-
Constr Contr. Number I'IG51?C/
Expiration Date /f2iIJI/ I) "2-
Signature of superVi~g Electrician
Y fA/l- 0/ .
Owners Name (A,tCiL~\...J -}~(,;("~
Address )\ I \ f('\I"'\~ f'K_f(--'--
Ci ty C'fl. ,J<:'&1(",,-O Phone ()\1\)"\\,ll,.' ~'n.__
OI/NER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: D'1120 /
RECEIPT #: /.( <;/0
RECEIVED BY: --:-....... (('
200 amps or less
201 amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see flB'1 above
D.
Branch Circui ts
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each.installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
-.L
$ 40.00
$ 40.00
$ 20.0~ :::i
$ 3-6.00':;:;55
:;0 ,_
fl1 fTl (.1")
.---n .. "*
2'g CD"
__ --....0
CJ) 1'.J;o~
- I
~("')~t-La
~ Cl2:j'$<J' ,,) g
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om. 0....0
O'--mO"-Oj--L
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5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL