HomeMy WebLinkAboutPermit Electrical 2001-5-3 (2)
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'.I~~FIELD
',' , "" c\ as sUbm;t\edhasct~:n~ use DATE: MAY 03 - 200i
, lhO 10110winQ p~~~e not 'raqui,e speclIl, . ", " , AMT REeD: 2 $ 40.70
zoning, and d ,<no' n, ',," "~ CHANGE:
app,ova" 'r-~ -' '
CASHIER: 061
Zoning~_,?_o \ Ii . :='ELECTRICAL PERMIT APPLICATION,
~T ,"1'\_ " ,
iZ~~9ignatu'e - Ci ty J~b Number 0/-00 '-129,' -0 /
..p'-
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION OF INSTALLATION
/00/ mA-no/ ,T~"-r-'
LEGAL DESCRIPTION
1703 '3S-"3>/ '
0"5 ?,o'Q
, JOB D~SCRIPTION '
,=....-ktl -1..10 '-L;~
C,:a _. -:-fs.
Permits are non~transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days. '
2. CONTRACTOR INSTALLATION ONLY ,B_
Electrical contracto/\'SEIC'C;\Yl'c...;~IC.
Address 0,0. GO/- \L\q)... ,
Ci ty~l)/\ \'jht'ld Phone ILfl-223~ :
Supervisor License Number )10 ~ IS
, \ 0 --,()I-Q I
3?y,Q
{)-01-02
Expiration Date'
, Constr Contr. Number
,Expirat{~n Date
SiCL:{f
o~-Irs Name
Super~isirig Electrician
~,Jl
v '
$14(3
Address ~c::?, E'd -/ 3<:; 0
City ">PFi~ 'Phone7{';'1<>?Z7
OVNER,INSTALLATION
The installation is being made 'on '
property I .'o~n ~hich is not in~ended",'
for sale, lea.e ~r rent,
Ovners Signature:
DATE!
RECEIPT #:
RECEIVED BY:
())--o>~,l
5/'51"
~t?
'3: COMPLETE FEE SCHEDULE BELOV
A,
Ne~ Residential-Single or
Multi-Family per d~elling
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular, 'D~elling
Ser~ice or Feeder'
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 am~s to' 1000 amps
Over 1000 amps/volts
Reconnect Only
uni t.,
Cost Sum
$ 85.00 '
$ 15.00
$ 40.00
Items
$ 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 100u
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "BII above
Ne~, Alteration or Extension Per Panel
.'
One Circuit ( $ 35.00 ~~
Each Additional
Circuit or ~ith Service
or Feeder Permi t I $ 2.00 7
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
no t included)
$ 40.00
$ 40'L
$ 20. o=ti
$ 36. :D
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