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HomeMy WebLinkAboutPermit Electrical 2002-5-29 225 FIFfH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 '. ~ ~ 0 ,01.- ELEC-rnA PERMIT APPLICATION (' il. 0 I) TRANS#: 01-0009288 ~ I V Cily Job Number 0- - D 0 ~1(P~O ( DATE:MAY 29 2002 ~ J-l_ AMT RECD:2 $ 167.50 \}J '!l. COMPLETE FEE SCHEDULE BELOW CHANGE: CASHIER:061 A. New Residential-Single or Multi-Family per dwelling unit. Service Included: I. LOCATION OF INSTALLATION &:-, LA II VY\ A. ~ () "'Sr: LEGAL DESCRIPTION /7. O.a. ~'I' ~?_' ()?"\7!7) Items Cost Sum lOB DESCRIPTION _ 1000 sq. ft. or less ~eJ...:> 1'",-'0\ ""'" 0'.) F\I;S-\-.,,".. Each additional 50 pc.,,\". ~..,-'--- o~ ol.-b ""'~;:) t\ p.lD. crNer sq. ft or portion Pennits 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 $106.00 $ 19.00 $ 50.00 . 2. CONTRACTOR INSTALLATION ONLY H.~-~s\(rN Electrical Contractor .,",::>~",,., -L 1>.,,)<,,;"0. B. Services or Feeders Installation, Alterations or Relocation: Address ~=:, . '5. ~ "::>T. SU:,k \ 15 Expiration Date I..{ . \ '8 . ok! 200 amps or less $ 63.00 201 amps to 400 amps $ 75.00 40 I amps to 600 amps $125.00 601 amps to 1000 amps _ $163.00_ Over 1000 amps/volts _ ...iMC\\\'iQ 5.00 Reconnect Only \~t \i "~'o.oo ~ c. ~l~~~i~~:~t~~ iO~ ~\~I!l (>.\)I\S\~W'~~~\O\)' c. '_~'to amps er 40 I to 600 amps Over 600 amps or 1000 volts see liB" above $50.00 $69.00 $100.00 Cily.59""~,\~I'-L",--Phone~lo. ;:z,;>,I.;;2 Supervisor License Number _.0't' S}q , Expiration Date 10 - 0 L Constr Contr. Number I;;J 'i1. 6'i'.w s;;zrv~ Owners Name -:S;"""" los::, Address so 7 '-( rnhAl S'l D. Branch Circuits ~o.;; \0 New Alteration or Extension ~erJPaneI\~\\'l ~'Co , _ ~ (1301. ~eQ,O\' ~e\ \~()\' One Circuit ",-~'\.;t> ~eO e'O'lJ.(e ,,';;:$4:?,;Q(i,_ .0\'<>'" 0. 'Q'l e (.;;~ 01'-'" - (.;;\0 e Ea h Add' ""naJ' ;;!.e ..n'!i ",-'<:oS .L~",e "'0'<' c ltiO (uucnkor,wlID elV1Ce,.<'o" ~."o~ c.'~ c,'().- :\ :(\''"' ~.... ;;.,,"''' ~" o:;'l.'eed~p~t.,\\e()~\~'1 co~\~"S",\e :'{s:3. 0 _ .o\\O~ ",\\0(1" f:\()'\' ,,'Q\'lJ.\(I\~o\e:\~,,'l ~b.'" E. Miscellaneous (SetVicelfeeaer;notJncluded)J !~chl!'fsUillalio'iI "ce(l'O- ~eg ':"".'f,!:><- \(\ - n. \ - "':..,..... e fO\J\J Pti,\%'OrJ!m,gatib1l;\X' \'0 \' $50.00 Si~01itfi~~&it~~( I $50.00 ")0.0<> Limited'BllergytR'es $25.00 Limited Energy/Comm $45.00 Cily S f' r,~ Phone '7 gg -,-(3'l''f OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: T90:~3IHS\j:J : 39N\jH:J :a:J3~ lW\j ZOOZ 6(; A\jW: 31\ja 88Z6000-TO:#SN\j~1 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee So.OO ~. 'OD Y.oo TOTAL S7 . 'bD