HomeMy WebLinkAboutPermit Electrical 2000-12-28
.
DEVELOPMENT SERVICES DEPARTMENT
'II d haS the following
. tassubml e d use
T\1e lallowing prolec t require specific Ian
zOning, and does no
225 FIFTH STREET approval. c.. a.-
SPRINGFIELD, OREGON 97477 zoning I ~ _ ~,,- 01) l
INSPECTION REQUEST: 7~"T~I6.9- cr,;"J
OFFICE: 726-3759 Signature
IUtl)onzed 3 . COMPLETE FEE S'-lUWu..E BELOV
1. ~ATION OF INST~ION. ~
Me t<e fI 7/(:> 1111 1'".11 ( CUII/C; (;)a:3 tJI"y/ A. New Residential-Single or . .
, 5frrl}'J/lt'~ Of( Multi-Family per dwelling unit,.. '
LEGAL DE,SquI7'I9,N,. 91~7r Service Included: ':'! '
("cn1Aferr/a~l/d//7J' Items Cost, Sum
... JOB DE~CRIpION 17o>333( 01303 1000 sq.ft. or less $ 85.00'
';:>CC-lh"lh SY<;.,Ie_ fAr",. // Each additional 500
----, sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX(541) 726-3689
ELECTRICAL PERKIT APPLICATION
Ci ty Job Number Db ~Oc) :3 70 r 0
Services or Feeders
Installation, Alterations
or Relocation:
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLAl'IPNQNLY . j B.
PI! e {frC{1Jf qr>1tt V
Electrical ContractorR.PI ~eGtltit!tj,s-r~mf
, ~I' '
Address (0 /0 71 ,:a,,2-r ~ 200 amps or less ,
C" / -' 201 amps to 400 amps
CityC-uctble OfL- Phone9l1 3rs;~7'I, \ 401 amps to 600 amps
~~ , 'I . \' Ilel601 amps to 1000 amps
Supervisor License Number"3 -/71/ LLf Over 1000 amps/volts
I \ \ I ' Reconnec t Only
Expiration Date ~ 0 I n
\ ,'-1 !/j~ C. Temporary Services or Feeders
Constr Contr. Number~1 Installation, Alteration or Relocation
10\ dol .
Expiration Date
Signature of Supervising Electrician
~Oaft ~
Owners Name ~~, Jc-cS ;;/'
I
vn ;4-1/<.(
Address
5'31::> .,-
U.4---h:........-.
s+-
7'16- "032-9
City
c;. p p..j
Phone
OIINER INSTALLATION
The installation is being made on
property I own which is .not intended
for sale, lease or rent.
,
Owners Signature:
DATE:
RECEIPT 11:
RECEIVED BY:
I 7 Z '6 00
4/2b _
i\(!.
$ 50.00
$ 60.00 '
$100.00
$130.00
$300.00
$ 40.00
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
$ 40.00
$ 55.00
'$ 80.00
volts see "B"
D.
Branch Circuits
above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous '(Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm ~
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$
2.00
not included)
$ 40.00'
$ 40.~ ---j
$ 20.00""7-'
...". ..,
$ 36.<w;~
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