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HomeMy WebLinkAboutPermit Electrical 2001-12-3 , . . 1'tI"-- \0\\0 . \'(\0 ~",0 '(\e'" \e<:>6 ~~~~\C 225 FIFTH STREET "",,,, "O't" SPRINGFIELD, OREGON .?J'~~o\ I~ INSPECfION REQ~~<:>~"'3769 OFFICE: 726-37{io9'\~~. e<:> 1.0'(1\ ~o-Je.\' ~\(\~ 1. LQCATIONO,~STArL lo\.D ':77 ttZE ~~ _ " " (\ 'Oe.~ 1.00. .. 01' LEGAL D~RIPTION>-"'l' ncn..: \\ ~~LC/) , 2201 J~~~~~~~~ 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