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HomeMy WebLinkAboutPermit Building 2002-4-8 03'_ .\.....;" . . ELEACAL PERMIT APPLICATION cily Job NUlllber (J.2- OO~/ - 0/ 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 * The following proiedasGlilMli\l>li:ilB r~Iio~JliDULE BELOW I. LO<;A nON OF I.NST ALLA Tl0N"ng ana doe, not ,equi.. specific land use :J I J V YV'\UAV, "iLr LJ'ilp,oval , A(l'I~ Residential-Single or J Zonmg _' ~ f.1Hlti fBfRilj' per dwelling unit. LEGAL DESCRIP~ION 0, ale Jf-<{ ,iJ, -:r- \ Service Includ~: 11.0."i',"i/.. 2. Ol.'100 _ O')J Items ~ '-"'-"-"''' .:ngnahHE:: JOB DEScRIPTI()N I . AnENTiOI ',_ , 1000 sq.fl. or less . ~ lAU.-<.1L f~lIn"'rul .~.OrE::~Each\additi,wp~500 U NotificatiDne~ adoptesqbjl t1ffPl!l1ill3o~~~/~ Permits are non-transferable and expire;n OAR 952 0 enter. tlitnefru/eS~'i_S~J f~ y if work is not started within 180 days 0090 y, - 01'00103':ill1!l~1'eJ; ~~(j(rth of issuance or if work is suspended for caliin o~hmay ObtalMoI!JV!!!'g:ny~ m~O I -001- 180 days. 9 e center. ~~~bli.#1[tU es by numberforthe Oregon uii/;'t I .~no~e 2. CONTRACTOR INST ALLA nON ONLY CentrJr iSei-YlCe}.g'<J~ifiJitlflcatJon ( 1 {' El ~ InstallatIOn, ~1terations or Electrical contractor_.I1u eCTYJ'c,..Lrc.. Relocation: Address f. o. flm lL\.<r 1- ci~pYi~R(ldphone t4-i-~c:' Supervisor License Number ~4-~ loll 1m constr contr. Number ,~~ q!l/DJ..- Cost Swn $106.00 $ 19,00 $ 50,00 Expiration Date 200 amps or less 20 I amps to 400 amps 40 I amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163,00 $375.00 $ 50.00 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date ~? . D. Branch Circuits Owners Name ~~t~, L EXPIRE IF THE WORK AUm6RIZED UNDER THIS PEA'Wlrr~'MYfn or Extension Per Panel Address ?D. ~ ~D OR.IS ABANDO~ffil:tit -L $43.00 A- ANY 180 DAYRERIOD. cily~t(!l~ Phone_c'S?)~?4!'l Each Additional Circuit or with Service _ OWl'@i. INSTALLATION or Feeder Permit ...!:L $ 3,00 ..ifL 200 amps or less 20 I amps to 400 amps Over 40 I to 600 amps Over 600 amps or 1000 volts see liB" above $50.00 $69.00 $100.00 Signature of Supervising Electrician The installation is being made on properly I own which is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation SignJOutIine Lightin" Limited Energy/Res Limited Energy/collllll $50.00 $50.00 $25.00 $45.00 Owners Signature: 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee ~"- ......._-.... - ,,1)'..,..:.... .-.........." /fr.O;LJ <IF gO. S1! C!.k- -JI.. g$€5 @) TOTAL .. (0. 50 --.'-::0... ~ . EL.lRICAL PERMIT APPLICATION City Job Number ()9... - ~ifbl -0 ( r' ,IJ ' , '1-'" '\' " 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 3, COMPLETE FEE SCHEDULE BELOW I. LOCATION OF INSJALLA TION 2-l4,n M tA .r.Vl ~. A. New Residential-Single or Multi-Family per dwelling unit. Service Included: LEGAL DESCRIPTION _\ 17, tJ3. "\ (" . 42.. O.:l.lltTO Items Cost Swn JOB DESCRIPTION r~' FI'f - , 1000 sq.ft. or less . .-t\e@y1CMWovk.:\1l1r,r, r 'ON:OregEacn'aildilional~500u to ..~,v ru es adopterl.h"'t"~ n . Notificat' Sq"n ""'r'J..J.".m Utility Permits are non-transferable and expiren OAR ~~; Center. li\l~fules are set forth if work is not started within 180 days ~090 '1\ -oOl-001~~~~niitl\fH.om..e.SD1_ of issuance or if work is suspended for ir ou may obtaiNI6dUliIf!O.\f~IIWglJ/es by 180 days. ca '"g the center. ~k:e:bp.If~~one number for th~ Oregon Utility Notification 2. CONTRACTOR INSTALLA TION ONLY CenB'! Sei-viceS'&.:Eemlt). . fl -'S 1"J 17/J-,_'/, , (\ II\f'l Installa~ion, Alterations or Electrical ContractoU t::;l:c01 nv,J>1 ..... . Relocallon: I, $106.00 $ 19.00 $ 50.00 Address ,/ City ~Ph~"1 /' Supervisor License ~ ~./ Expiration D I 200 alllps or less 201 amps to 400 amps 40 I amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375,00 $ 50.00 NOTlG[: THIS PERMIT SHALL EXPIRE IF ~6 ~Q~K less AUTHORIZED UNDER THIS PERM'Olls.JIlD% 400 amps . nature ofSupervising~rJft!m::ED OR IS ABANDONE~ft{!lftol to 600 amps , 80 DAY PERIOD Over 600 amps or 1000 volts see ANY 1 . "B" above C. Temporary Services or Feeders Installation, Alteration or Relocation $50.00 $69.00 $100.00 Owners Nam('\feVen ~ Address ~,O .\VI-}-l 210 12-f) Citv F~et1V Phone9)I-::#'bl owNER INSTALLATION D. Branch Circuits ',' ,I New, Alteration or Extension Per Panel ,/ " One Circuit --L $43.00 1J..!D . Each Additional Circuit or with Servicn 'l~ {)D or Feeder Permit -:::L. $ 3.00 cZ:.L The installation is being made on property I own which is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation SignJOutline Lighting_ Limited Energy/Res Limited Energy/Comm ~ TOTAL $50.00 $50.00 $25.00 __ _ _$45.00 , -, i <t '1~'-7'7:-"'-' ~ ,"Ii' ._,_..___._' .~ " I t:="t06 , 4lt<h-SD Owners Signature: Gm: ~mHS\J::) : 39N\JH:J OS"OB $ G:O:J3lJ lW\J GOOG BO lJd\J: 31\JO ~S'S'BOOO-10:#SN\JlJl 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee . . ;;. ,~'/"--- " . " :": \~:'.".;:': :'.. ".:' .'~' . 4-.I~ ,JI o \J-'S~fi\ .fG' :\ C\ Ie- \v \\)C> ~ \---D . a>\ ~o~cy~