HomeMy WebLinkAboutPermit Electrical 1999-4-23
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ThO fOllowing project es submitted hes the fOllowing
lulling. end does not require specific land use_
225 FIFTH STREET "pproval .t;L.t.CTRICAL
SPRINGFIELD, OREGON 97477 Zoninr' c,C-.
INSPECTION REQUEST: 726-3769, .L(- Oi '3 _ "j'a
OFFICE: 726-3759 Date J' \.. I
AtHhorlzea SlgnaturCl ~
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION c
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JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started Yithin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
.. Electrical Contracto{)/2 F:1<""t;::z;...<;';"wlCA.-
'~ddressP() fA,.,,,, ~..;-:), \ '
~ Ci tyG:u-...,,,,,-,,_ ql~Phone~L/-, ~ - r !nt:;( t
Supervis~ License Number (~~q&~ <\
Expira.ion Date' II') - 01 - ~~
Cons tr Con tr. Number _ ~ V(Jm ,
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'-.1l/ Job Number
PERMIT APPLICATION
9'1010 /
200 amps"or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u
Branch Circui ts
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COMPLETE FEE SCHEDULE BELOl/ ..
Nev Resiciential-Sin&le 0:
Mul.i-Fami1y per d.ellin& unit.
Sen'i ce Included:
One Circui.
Each Addi .iona1
Circuit or vith ServicE
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res -----
Limited Energy/Camm
A.
Items
Cost
Sum
1000 sq.ft. or less $ 85.00
Each additiena1 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home, or
MR~4tMTRYI~~.\.ll!bn law requires you to
16lig~Hulgs aaof\\\!\Jby the OregO$ll.4t)1itGo
.t.lnli' . 'on C~ter Those rules are set forth
:?eTV~I~~'b-5O'i~f(;!hrOUgh OAR 952-001-
11lB~ \~i;toJl &jh~,tTf~OO[Qf the rules by
cIfOi/!h, e!,l~gx: ter (Note' the telephone
, call1ngt ecen. U'Tt Notification
20()1li1iill1gr!w tM/Jregon tll y $ 50.00
201 amps C'@ItiO!ll Wp-~44$' 60.00
401 amps to 600 amps, $100.00
601 amps to'1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnec t Only $ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
The installatfon is being made on
property I own which is not intended
for sale. lease or rent,
e:. .'rers Signature:
DATE~-v~~lii--
RECEIPT' "i /j.5 $ b iff) /1
RECEIVED BY:' ..~./ tJ-V'",
.B.
$ 40.00
$ 55.00
$ 80.00
VOlts see "BI' above
New, Alteration or Exter.sion Per Panel
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL;';,~,
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Expiration Date ~" {</-- 00
Signature of Supervising Electrician
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Oyners NameCnfY\MItJr:{, Jll J r ". 1IP"i-tnJJ...::t'
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Address \Irn-->' J. \ \.0,. \?"l u"L- (),.{ ~
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Ci ty Cu..o. &---t Chllnl Phone ~<i<:\n -<iff)~'"
Ol/NER ~STALLATION
$ 35. 00 .~ ....,
$ 2.00,
not included)
$ 40.00
$ 40.00
$20.00
$ 36.00
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