HomeMy WebLinkAboutPermit Electrical 2002-8-13
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225 FIF'rH STREET ~,o:..," ~ .\ .LECTRlCAL ~MIr APPUCA nos
SPRINGFIELD. OREGON~" k Q 72 0 I
INSPECTION REQUES~0'1~3769,~<} City Job Namber 0 Z -.~O 1 -
OFFICE: 726.3759 "-,,, o~-s' o~" 1,0~ ,0
l' ..~~' ~~tOMPll"E FEE SCHEDULE BELOW
1. LPGA.JJPN q~~TM N c,'Cf,
.. _hb'bb 1J1..~ ^ ,~ A. New IU>ldeadal-5lDile or
?-"'~- Multi-F&mIly per d"elJio& uait.
LEGAL DESCRIPTION Senite !odudcd;
, LJil /'7LJX7'\
170z.. 5-UL-. v.Ln....
U~iU.:iU;:
JOB ~SClUPTION J LJ
_ st; WI. fZ-(!"" ij T/;;?tA..
I -
Permits are non-transferable and expire
i! work is not slllrlcd within 180 days
of issuance or if ...ark is suspended for
180 days.
2. CONrnACrOR!NSTAI.LATION Ol'oo"LY
Electrical COIllJUCtor '57D1",o/lN'1 ELEc!'7?Z...
Address 9E7 F~ ~. .
City._~~ .PboDe 6Ee :Elk
u
SupelVisor License Number :1... 9oo-L
Expiration Da'c 10 - / -01/._
Constr COJ1lr. NwnbeT :Jo -Iqi/e. .
Expiration Dale' 10 -/ -0 :J_
Signature of Supervising ElectriciaD
~ ~1'~
V
OwnmNameJ3f......c:.e- iJt~l--.crv+
Address "537 5" ?frII--~ -Jo11 S
Ci~W,l::7VtE ._Pbone.../:;K6 . 9'()(
I
OWNERINSTALLAllON
The inslallalion is being made on
propeny I own which is Dol intended
for sale. lease or fent.
Ownen Slgoamr..
890:i:J3IHSti:J
: 38NtiH:J
V~'~O~~ $ G:O:J3i:J lW~
GOOG 9G 8nti:31tiO
9~vOl00-l0:#SNtii:Jl
li!l uo~
1000 sq.ft. or less
Each additional 500
sq. ft or portiou
thereof
Each Mallufd Home or
Modular Dwelling
Service or feeder
!tam Cost Sum
.J. SI06.00 JE.... b
2- S 19.00 3 CZ
S 50.00
B. Senices or Feeders
JnsraUalioll, A1teralioa. or
Relae:uloD:
200 amps or les.
201 amp. to 400 amp.
401 amp. to 600 amp.
601 amp. to 1000 amp.
Over 1000 ampsIvolls
R<:conDect Only
$ 63.00
S 75.00 -
5125.00
S163.OO
5375.00
S 50.00
C. Temporary Servic.. or Yeede...
lnrtallalioD, A1teraliOD or Helaeallon
200 amps 01 Ie..
20 I amps to 400 amp.
Over 401 to 600 amp.
Over 600 amps or 1000 volts see
"B" above
.~ S50.oo ..? ()
S69.00
5100.00
D. Br&llcb CircuilJ
New A1leration or extensiao Per Pan.cl
One Circuit 543.00
Each AddiliOD.1l Circuit or with Service
or Feedor Petmit $ 3.00
E. MiKella.eous ($ervire/feeder Dol included)
-Each in.tal\;ltion
Pump or il'ri~ation
SigoIOutliue Lighting
Limited EnergylR.os
Limited linagylComm
S50.00
550.00
$25.00
545.00
MillimwD Electric Permitln.pectioo F.e i. $45.00 +
SW'cbargcs
4. SUB'fOTAL OF ABOVE
7% State Surcharge
8% Adminim-alive Fee
I '1'-1-
'~51>
/55'L
Ciz~
TOTAL
.
PAY TO THE ORDER OF
. SPRINGFIELD BR(INCH:
US NATIONAL BANK OF U~EGON
FOR DEPOSIT ONLY 1 536 0145 2508 .
CITY OF SPRINGFIELD
DEVELOPMENT SERVICES DEPARTMENT
AUG 26 2002/5503.34/01-0010436