HomeMy WebLinkAboutPermit Electrical 2000-4-10
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SPRINGFIELD
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oOlng, and does nol require specific land
approval. use
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225 FIFTH STREET Authorized Signalure . ct)J
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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L LOCATION OF INSTALLATIO)\) /J.
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LEGAL DESCRIPTION .
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JO}l D!>~CRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if. work is suspended for
180 days.
89
00
AMT ~ECD:2 $ 22.00
CHANGE:
CASHIER: 003
ELECTRICAL PERMIT APPLICATION
City Job Number ~ 9/3 If?'
New Residential-Single or .
::::.:: :::,:":,' <-
Service Included:
Items
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwe11ing
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
11 ;U .J Installation, Alterations
Electrical contractorL'.ih,~~h/u-I.v~k or Relocation:
Address;: 0'. f~..v// . 4'"or-~ amps or less
/1 201 amps to 400 amps
City(IA'~Ii/.t)~lt. Phone 7<t5-~~~- 401 amps to. 600 amps
601 amps to '1000 amps
Over 1000 amps/volts
Reconnect Only
Supervisor License Number
Expiration Date sf'.
"~-[ju -
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr .eontr. Number (}6// C}ij(')
Expiration Date
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Signa~of supervi~~ Electrician
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Owners Name
Address
City Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
fo'r :?a1e, lease or ren t.
OVri~rs.Signature:
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-~--------~---------~------------------
DATE:" \:,. .
RECEIPT 1I:.,...
RECEIVED BY:
D.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600.amps or 1000 volts
Branch Circuits
Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see "B" above
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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 Lighting
Limited Energy/Res ~
Limited Energ~/Comm .
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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DUPLICATE RECEIPT DUPLICATE RECEIPT
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CITY OF SPRINGFIELD
225 FIFTH STREET
SPRINGF[ELD, OR 97477
(541) 726-3753
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WELCOME 10 DEVELOPMENT
SERVICES AND PDBLIC WORKS
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REG-RECEIPT:Ol-0DD1189 C:APR 102000
CASHIER ID:003 1:55 pm A:APR 102000
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1004 ELECTRICAL PERMIT $20.00
JOB~:99-0139B-01
1099 STATE SURCHARGE(7%) $1,40
JOB~:99-01398-01
1098 ADMIN FEE(3X) $0.60
JOB~:99-01398-01
T01A.L DUE $22.00
RECEIVED FROM:
VENTRAL-FLO BUILT IN VACS
CHECK: $22.00
TOTAL rENDERED m.oo
CHANGE DUE $0,00
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*Pay Name :VEIHRAL-FLD BUILT IN VACS
*Mail Addr' :PO BOX 416
*Cty/St/Z :CRESWELL OR 97426
*Site Addr :862 MCKENZIE CREST DR
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'f unNK YOU!!!!!!
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DUPLICATE RECElPr DUPLICATE RECEIPT
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