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HomeMy WebLinkAboutPermit Electrical 2002-9-18 225 FIFTH STREET .' e, ELE.CAL PERlvIlT APPLICATION SPRINGFIELD, OREGON 97477 . . INSPECTION REQUEST: 726-3769 ~",.,,,, J Number O;{ - 0 III C, -0 I OFFICE: 726,3759' "0"''-\ ,i<S. , ~o~ <;:-0 " ~<i 0" I , \ I. L.oCATION OF INSr~Th~I~N' I " b '7 ~ 7 rvt \~~~f", ~_<<-~ ,: NcwRc~idcnti;II-Single or (~~\"'~. 1:;&'.,<,,- Multi-Family per dwelling unit. LEGAL DESCRIPTIOit~ ~# Scn'icc Included: 1/. 02. 6L.t, II ., 0 (P<:$ 0 ~~ <a ..\(\~ Items Cost Sum ~~: ~ ~~ I ~^~ DU'1.RlP'H,ON .1 M .\.ri" ~~' \~~OOO sq,f orless ~$106,00 -W' \M f'\...J f'J(;. (.,j 0\'\ 5 J< . \;, Eac diti nal 500 , \0c\oe.'::I..eO,,>J\, ft 0 rtion ?- 5EQ:J . c ' ~<o, (\0' arc non-translerable and e",ll.\1'3 0'" ( eof _ $ ]9.00, if war is not started within ] 8.\\.tl1)-~(\0 00 Eac anurd Home or of issuance or if work is susP'e~-".<>\)jpl'. ,(\~ odular Dwelling 'f!1";,~o . "'0(\ . 180 days. e~Y'" ServIce or Feeder $ 50.00 ~\10..0 2. CONTRACTOR lNSTALLATp O~'~(\~ B. . o1.''f; c.:t p.."\'(\ - / Electrical'Contractor0 OODaIl/ 1= let! . f' / Address 9t7 FCllJI'/;/;I_ tf-vt. / ,\1 /' City ELI 0 r? 11-& .' Phone 6 rJ6.-.C SrJ s-O . J , Supervisor License, Number.1 q /J/J ~ Expirati~n Date..1tJJm./.1 Of)!f . , /Constr ContI'. Number o! to 6.t If 'E~piration DateC,/rIli1. !)()3 S;fj;~~'riri'" Owners Name Bv-lA...U- Lv Li. ck.uJ;: Address '5~I~ pM-it.. 1<l"Ll~ City [.v-~- v f.o'in; - OJ 4~"t Phonc OWNER INSTALLATION The installation is being made on property lawn which is not intended for sale, lease or rent. Owners Signature: Services or Feeders Installation, Alterations or Relocation: ; 200 amps or less 20 I amps to 400 amps 401 amps to 600 amps 60 I amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 63,00 $ 75,00 $] 25.00 $]63.00 $375.00 $ 50.00 C. Temporar)' Services or Feede,'s Installation, Alteration or Relocation R>i- ~ ~~ r,\ e1\cP 200 amps or less Co \'( ,Y\ ~ \S ~~ $50.00 ..:LL, 201 amps to 40?!,~'s- ~~~\ ....\j'b..- $69.00 _ - 'Ol'er401~\.~an~~(\~~'i) _$100.00_ \~~'Ov~,\eab'~~~'\'1~~rts see ~'\:J'\ \,{.J;l.'~~~~ \S \>-'0 ;.,\\\~ ~ R>\1.~ \). (J~ ~\\j'i). D. Br.li~r, ~\'l~~~ . \>-~(J,~1\\'6lUlBtJon or Extension Per Panel ~'\ \ ~ One CIrcuit ${l.OO .''''':l .. \~\\" ~ ,\J., \.t Each Additional Circuit or'wilh\Se'ivice (\l'''',:)'' or Feeder Permit '\).0\ .\~"~,,0 U ~ ~:.).\l\ ~r$'3~O:.\ . . .\,)~e-n'O'l ~\}\"'" \)I"" . ~J .- ",;.\.. ",3 "",e "'()~" ,\ \" E. Misccllaneolls'(Sel;vice/fee'der not1lnclullcd) ""I)', .'" '....,- :C'.U' 0..\ . ~_v~- V' \\;\~p :,('!\ ..,Each tl}Sthllatjon- ~\\}'i! . 09\13'" ,,\C ',,\w'3' P,lIhip'lor,,'.irfi~lion'\'j ~.i\\\c; o'e"~: .~"$50,OO . 'l/,,'_'(J,' I"t\..... .....,t" t~~" '\\\.) ,." - .~,i.sifl~~~I!fie'LJ1!h\ing"e"'': '" 0\\, r $50.00_ Lil(lLted' E'.'~rk);~~~e>~ O{eQ-P 0:"~ $25.00 _ LilnilciiJEner""'IConufi' ~ .~C\ $45.00 ,).... .~\"'b.. \0'''' ...~,t-,' - C"l' _'013\ -'i.:'~' Minimum Electric Pcrnfi't1'nspcction Fcc is S45.0f) + snrcl0:5cs 4. SUBTOTAL OF ABOVE \ct4.. 7% State Surcharge ' loA ~ 8% Administratiyc Fee \ ~2.. Q,I).~ " \D TOTAL