HomeMy WebLinkAboutPermit Electrical 1999-11-2
-.
, bmitted has the following
Tl1e following prOject as su ire specific land use
zr)n\flg. and does not requ
225 FIFTH STREET approval, () YY1.0 1lLECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ZOning \ \ _ d. -90 .6.o../_4:'""/.r-
INSPECTION REQUEST: 7t,~f,,3769 'vi 'y Job Number '7/.r;"h"=>
OFFICE: 726-3759 (\p *
J.\ulhonzed SIgnature _. ~ j. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
474f) fYla/J'J Sf.. A. New Residential-Single or
Multi-Family per dwelling unit. .
Service Included:
LEGAL DESCRIPTION
/7~?'3"::?V? ~/~J
JOB DESCRIPTION
in.<:;f11/1 :<=;eo.l"n't-v
/
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
It ems
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Sonitroi Security or Relocation:
Address P.O. Box 21009
Ci ty Euuene
Phone 461 - 5678
Supervisor License Number /t,flC/ R..E. r
Expiration Date 10 -/-qq
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
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
S 60.00
$100.00
$130.00
$300.00
$ 40.00
Cons tr Con tr. Number 65149
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
6-28-00
Si~;;r~~ Electrician
Owners Name .<::n/rJ,,, fn-ff'..rpr'-,<f'-<
Address~4() E. main sf
Ci ty 5or/n:JP;dd Phone 747- 79t){)
,
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: I" A. ~~
RECEIPT #: ~C.....7.,-r
RECEIVED BY: /,i,/.?""""""--
'/r-'
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
S 55.00
S 80.00
see "B" 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 Lighting
Limited Energy/Res
Limi ted Energy /Comm I'
5. SUBTOTAL OF ABOVE
~% State Surcharge
3% Administrative Fee
TOTAL
S 35.00
S 2.00
not included)
$ 40.00
$ 40.00
S 20.00
S 36.00
:3'=> /JO
.;1..5;,1-
IO'lr
. =?9. t;,r)
~t. <nl