HomeMy WebLinkAboutPermit Electrical 2001-6-5
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DEVEl.OPMENT SERVICES DEPARTMENT
Th.lollowlng project as submitted has the followin
, d does not require specifiC land use
lVnlng, an
a~lJroval. J-l>(1.
zoning
9747,7 -10-.5-0\-
726:'J/b~
,;"U{rlvIILeo SignaturO
225. r~r.o ~1~.
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1, LOCATION OF INSTALLATION
/;:; C:; 3 mc<-', f\ ~u 'it- :Q
LBGAL..PESCRIPTION
no ,>.s.:s4 /
225 FIFTH STREET
SPRINGFIELD. OR 97477
(541,1726-3753
FAX (541) 726.3689
&.KCTBICAL PERMIT APPLICATION
City Job Number (')/- 00",1-,7 -0 I
3, COMPLETE FEE s...u.uu..E BELOV
A,' New Residential-Single or
Multi-Family per dwelling unit,
Service Included:
08700
JOB DESCRIPTIO~
j6o~""/I('a
Permits are non-transferable and expire
if-work is not started:within. 180 days
of issuance.or if work is suspended for
180 days.
2, CONTRACTOR INSTALLATION ONLY
Electrical Contractor;::\~\e..ElQCA'~~L
Address l'7.0n ~Nf 0 C1"'),,\ l .\-41f\ L
Ci ty SOCl \.) Phone '/,)[,,- CLf} 0 I
Supervisor License Number~ri:J ~ .
Expiration Date 10/01 j() I
Constr Contr. Numb~rJO"'1(Of)L
Expiration Date_ / f) )0/ /D::;l"
- Signature of Supervising Electrician
1000 sq,ft, or less
Each additional 500
sq, ft or portion
tbereof
Each Manuf'd Home or
Modular Dwelling . '\
Service or Feeder
B,
Services or Feeders
Installation, Alterations
or Relocation:
Items Cost
m
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 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
~
fl ~~ ~
j~~.-, ( 'f" 1(~~,~, J D.'
Owners Name~D '9f)~, (LJKil!~_Y'I'7'"
Address r2G') mJl-14 S~
'9 P ~[J
City
Phone
v..OM> INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent_,"
Owners Signature:
DATE: oGo)' 0 I
~...i'II:.
, .--
/I,..,h'\
-
o~
./-
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
volts
$ 40,00
$ 55,00
$ 80,00
see "B" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Camm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
, E,
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
$ 35,00
$
2.00
not 'included)
$ 40.@ ,
$ 40,EHli:::l:::a
$ 20,gg~7
$ 36 , Ql}'.'.' ~
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