HomeMy WebLinkAboutPermit Electrical 2001-12-3
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225 FIFTH STREET "",,,, "O't"
SPRINGFIELD, OREGON .?J'~~o\ I~
INSPECfION REQ~~<:>~"'3769
OFFICE: 726-37{io9'\~~. e<:>
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1. LQCATIONO,~STArL
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LEGAL D~RIPTION>-"'l'
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, 2201
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Permits are non-transferable and exprre
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INST ALLATION ONLY
Electrical Contractor STE.Ur:. t+A\JcI<.
Address ~b.g 5 l.j,ib' 5+
City~ri..p;dJ Phone 22.1 - 2-6'.5
. -
Supervisor License Number :5.5 ~T ...s
Expiration Date 10 - ) - z. 0 () ]
Constr Contr. Number ) 4~(, Ie
Expiration Date
4-30 - 2.003
Signature of Supervising Electrician
zt~.
'1J~-1.'l6<.j
ELEcrlAL PERMIT APPLICATION
Job Number-O\ .()\ ~~\ .0 (
3. COMPLETE FEE SCHEDULE BELOW
A. New Residential-Single or
Multi-Family per dwelling unit
Service Included:
Items Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
--L $106.00 JQ(p
3 $ 19.00 ..!:;[]
$ SO.OO
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
20 I amps to 400 amps
40 I amps to 600 amps
601 amps to 1000 amps
Over 1000 ampslvolts
Reconnect Only
$ 63.00
$ 75.00
$12S.00
$163.00
$37S.00
$ SO.OO
C. T ~..,....<Jy Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 40 I to 600 amps
Over 600 amps or 1000 volts see
"B" above
\ $SO.OO 5)
$69.00
$100.00
, C.... D. Branch Circuits
Owners Name U l... + e. New Alteration or Extension Per Panel
Address ~ ~ m 41 {' \J(". One Circuit $43.00
City ~ ('(j C . w'hone1:t) 1. ,lY)(o Each Additional Circuit or with Service
O~ INS1W.-'i:AtION or Feeder Permit $ 3.00
The installation is being made on
,....,...nf I own which is not intended
for sale, lease or rent
Owners Signature:
mO:~3IH;:;\7J
: 38NtiH8
~L'Zvv~ $ Z:QJ3~ lWU
l:OOZ OZ 83Q: 31tiQ
l:6~LOOO-l:0:#SNU~1
E. Miscellaneous (Servicelfeeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
$SO.OO
$SO.OO
$25.00
$4S.00
Minimum Electric Pennit inspection Fee is $4S.00 + Surcharges
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
rO '~~ .OJ
I .q I
~ _M.
&-44 .C{5
TOTAL