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HomeMy WebLinkAboutPermit Electrical 1999-7-13 . 225 FIFTH STREET Tho tOllowing project as subm," . ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON ~~7and does not require sed has the tOllowing C. INSPECTION REQUEST: Pf2'lr~~769 I D. {J, peclt.c 'and use Ci ty Job Number 1'1 0 v: Ur:JJ OFFICE: 726-3759 Zoning ! IV B~' Datp -1//77 14 J. "eM'" RTE FEE SCHEDULE BELO\l '-J 1. LOCATION OF INSTALLATION '.1./ Jz.~'1~ t~ AutnollfJll.l3igneture ~ A. Nelol Residential-Single or - v lI~}::4-Family per dlolelling uni t. LEGAL DESCRIPTION Service Included: 'I o~ 3c::: Lll ()(;,I(J7) AJTEr"'\-iON' Items Cost L..... .' " I ' :Oregon law "".Juires YOU10 JOB DESCRI.PTION 100~ foll~lIf f~le8ldpg!~ by the Ore~085J.t! ~:'''' ~\ ~ P "'" G rc...u....\ ~ Each O~~~af~G'~h:<f.Pl'SOcl h(,~" . u;"s are set orth sq ~n 'lb~5'P-b'l:'t iQi'n1 0 through OAR 952-001- penR1lCi~ non-transfer,}.9l.e,~l\ll.r~jCpire thBfl fYoU may obtain copies of ts,el!'JJ!lUlPY if WElPBlSMIi'OSH~\-'I.~tWdRijilt}l,lplj:VY~~ays Each ~Rl\1fl''h'eRod1WolNul'': II Ie telephone of ~eA'lta:eUNrfERCfflISp.cRfUlJpeM}ll for ModtPllffibW@li1"'m'gregon Utility Notification 18vcBWe:NCEDOR IS ABANDONED FOR Service ol?ePeedet-800-332-234$).40. 00 2, A",,,,,~REms\i)ALLATION ONLY .B. Services or Feeders ../. (' r.f r \ Installation, Alterations Electrical Contractor I\lclklr~~ or Relocation: l . Address ~ d<J:xJ(c-R... IC.k::. . Cityf.L~->'-LJl Phone ~ 17~\ Supervisor License Number "<fO\ S Expiration Date }O/o I Constr Contr. Number /OSC/ (7 Expiration Date I~;l~ Sign~e~;~~Electrician ~~ Ololners Name ~(L~~J! ~ \?{l, 9orl(. Address I z.c.,"J' (Vt-Q1t\ City~[lV\.-'t,~\~ Phone O\INER INSTALLATION The installation is being made on property I ololn IoIhich is not intended for sale, lease or rent. Ovners Signature: ~~~~~~!-~::~-9------~15\------ RECEIVED BY: n . mil 6h1Lri 0 200 amps or less 201 amps to 400 amps 401 amps to. 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only Sum $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less I $ 40.00 q.JJ. JU 201 amps to 400. amps $ 55.00 . Over 401 to 600 amps $ 80.00 Over 600 amps or 100u volts see "B" above c. D. Branch Circuits " Nelol, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit Each Addi tional Circuit or IoIith Servic~ or Feeder Permit C/ E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 /J., aV not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5;;< . C5V ?,~ C:> i .SG.> ,5~. IC-