HomeMy WebLinkAboutPermit Electrical 2000-10-27
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DEVELOPMENT SERVICE~AAR'7'MENt'ct as :~u"e speciJ;c land use
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Date. ~
97~~~oTlzeo SI9h&'h..ll'l::.-
726-3769
,-
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. I ~CATIO~N OF INSl'ALLATICW I
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LEGAL DESCRIPTION 0 If z.o ()
\ 703"3. S'-( I
l JOB I:!E~qrPTfON ()
J LP D:J:[!jI _./J I fY)/)r! L
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.'
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (54/) 726-3689
llt.ECTRICAL PERMIT APPLICATION
Ci ty Job Number(~() - 0 ( 5'9 S- .of
3.
COMPLETE FEE SCHEDULE BELOY
*
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items
1000 sq,ft, or less
Each additional 500
sq. ft ,or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
_~ _ " Installation, Alterations
Electrical Contractor~J-')I-1 r---C"Iff)J71:,or Relocation:
Address,;.) (jIoS / I "), / )'th 4::\::; I ~ 200 amps or less
r' '" 201, amps to 400 amps
Ci tye..UjE'. n(? , PhonU7. t") 7- -.:;{) 401 amps to 600 amps
. ' 'i 601 amps to 1000 amps
Supervis License Number,1'67,?7 ~'S Over 1000 amps/volts
Reconnect Only
Expiration Date ill /, /01
'. ,
Constr Contr. Numb,: .J6i:1.9;;l, q
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Ovners Na<ie cd. (y)l1.J\.0:;rn&
Address!JQ!()lt4 PAJ.1{, Jj-.
City E..u.a;/Ll..- Phone Tyll-f/l f3'1
OYNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
/0 27 en:::,
5h '2- 7
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Cost
Sum
$ 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
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
$ 35,00
?6. tfJ
One Circuit
Each Additional
Circuit or vith Servi~;
or Feeder Permit ~
E.
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
$ 40.00
$ 55.00
$ 80.00
see liB" above
$
~.DD
2.00
not included)
$ 40,00
$ 40.0@ -l
$ 20,00-':;:;55
$ 36, ocj:g rT1 u;
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