HomeMy WebLinkAboutPermit Electrical 2001-1-11
,
TRANS#:01-0004224
DATE:JAN 10 2001
AMT RECD:2 $ 39.60
, CHANGE:
ELECTRICAL PERMIT APPLICATIO~ASHIER:059
City Job Number n 1-00 0 ~a-01
The following project 85 su~mltted has the following
lonmg and does nol reqUIre specific land use
approval.
Zoning
225 FIITH. STREET <1.to
SPRINGFIELD, OREGON 9/4//
INSPECTION REQUEST.:jtf",lrl6a-Sig69ture
OFFICE: 726-3759
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1.
LO~ATION OF INSTALLATION
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~~ DESCRIPTION
/("~ T-q-(..-W oO;;;n,;;p:>=<, Q/qae
JOB DESCRIPTIQ,N
J-eU-4,f"~ -s:;,.r(<:j'1..
Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days. "'.,
Ci ty ~~~,
Expiration Date
ZD-'f-]JCLJ;.
/()- I-() I
13)mJ
/()/Zrlo2-
Supervisor License Number
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
~~
/" ,r. ~ / }......, _.Jl.
Ovners Name HtJ., "'- I -r ~,*-a..-~
Address :~9"'c~.
A' "vt-'~AAA'7"
UIHn,... Phone",.
....O';,,'~1~: '-<c:O u~-'- C:XPIA~
OIlNER INSTALl2I'r:fOtb 'D~AI/i, 1f:7Hc .
"vy leODA'- OAISA/;/ 7Sp~A. WOBI(
The installation is o'e("gr:made1I\Q..n'~1 'lliJ11'SN,E.
property I oVl'. which is iio/f). in ter~ae{iDf:OR ur
for sale, lease or rent. .
Gi ty
Owners Signature:
;-1'" 19/
<T :L..::l4
W5
DATE:
RECEIPT #:
RECEIVED BY:
3.
COMPLETE FEE SCHEDULE BELOY ~
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cos t Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dvelling
Service or Feeder
$ 85.00
$ 15.00
.$ 40.00
. $ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Branch Circuits
"
Nev, Alteration or Extension .Per Panel
One Circuit
Each Add it i onal
Circuit or vith Service
or Feeder Permit
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$
2.00
, .
c......." "t., I...
2. CONTRACTOR INSTALLATION~ONLY 'J"~'UI:o,... B~ )'Ser,vices or Feeders
Y)I v/..V }'H;I' I )t101 '..11. 1 .
-.to LOJII, '//:'1. Ol(l 0' nsta . 'atlon;:; A teratlons
Electrical Contractor rYrOrI,z'(9nf? '01ht71r. "'7ro<or;;'Re1oc~H\;'n:
"c'. -",,/ . ~f):o".'f '0".:> c ~et" -':
, 1/-"" J, I I/O, "" C}".~ O!;,~
Address .S 762- ~ '" I. J. , "vor",;ZOOfa.rrJP/i'<o!'OJ-ess
o " ',~v" ~l;120re.t.Jf}I!,sll<tob.400 amps
Phone 6f}9-<1t!1:Yf . .,;"401-0amps'J)to -600 amps
~-'60J;/,fn;-P'?ii')}0 1000 amps
Over 1000 ~mps/volts
Reconnect Only
not included)
I
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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