HomeMy WebLinkAboutPermit Electrical 2002-11-13
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225 FIFrH STREET . \ . <>~ fl,
SPRINGFIELD', OREGON 97477, ",,,,oIi,;
INSPECTION REQUEST: 726,~~,0 i
OFFICE: 72(i-3759, . . r:.<I':0"'" "
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I. LOCATION O~'~~LAI.J1llN ,
'07'18 '(Y)o5~~:O~0~~ "",0
POZ:,"{11 0'Jil CJOp' e}f"
LEGAL DESCRll'TION ~0 ""i>
Lot 8S- Lev', t.'^....a>~~o" f\~ If
JOB DESCRIPTION C\ -r ~ n,
Ne"-l 110 IY\ e....- \ _0 ft'\ \ .
Permits are non-transferable and expire
if work is n?t started within 180 days
of issuance or if work is suspended for
180 days.
ELEaAL PERlvIIT APPLICA nON
City Joh Numhel'..bri1lJJj) / ~\ 'Uo 1
COMPLETE FEE SCHEDULE BELOW
New Residenti't1-Single or
Multi-Famil)' per dwelling unit.
Sen'ice Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
Items Cost Sum
l$106.00 lUopD
n $ 19.00 -5-'1 r;tJ
$ 50.00
2. CONTRACTOR INST ALLA TION ONLY
B. Sen.'ices or Feeders
Installation, Alterations 01'
Relocation:
Eleetrical'Contractor $70fflMJl ;:;:u&...
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Address '1'87' FIf-YE7'TE. WE: /
200 amps or less
~ ~ '. 20] amps to 400 mnp,s
City e.ct{i'EM E. Phone Ga:> - ~o50 40] an\l'~'I\~GPl~rltp)
, '., . 'j.ljo.l\'W~~.,s \R~qcw\a~~s
Supervis?r License Number .t1'q,~\\ ,~:, II SW'\.'-- \:\~\301l'6~llln'E6Wlts
.0(. I . r7, ?r.\".~ 1:1'\0\..1' Rec~",~\il\&hl)'
Expiration Date (. () I :J..OO T , . .,,\1..\:'0 \\ \'2> flI\)l\\
'." --; 'l'\C'c.\l&. -Tro'poran Services or Feeders
Constr Contr. Number g 6 p/L cr,. -' ..\;;\~ \) 'C\jl.'i \'tfn'stallatio~, Alteration or Relocation
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Expiration Date r; 110 !4,<::JO.~ 200 amps or less
20 I amps to 400 amps
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y 1/1/'-' J' D. Branch Cir~lIits,,' ~\"f .~ ... _ ... -,
'Owners Name"lSr oAc...e I I e..d.t~r~ j>." ',j' '\;~"wtAltera~?I) Or'EX1~I,lS!OIfPer'~~nel
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Address '3>7 ) YMV \L. t< ~ i'o\O\i'iC0-\\O{'9~~,GiiCuit ,cf" ( . . r , '_ $43.00 _
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J' (?-b C ,.;.-,01"\ "f.' ." :\,~,- .~..
Phone bO . 1'I.tJ I:> ,:;)gO.'<O'~~cfl.~ddition~,1 Circuii or With Service
calli ~or Feeder Bennit $ 3.00
hellO' .
nUd'u I'"
E. l\Iiscellaneons (Senice/feeder not included)
-Each installation
. Pump 'or irrigation
Sign/Outline Lighting
Limited Ener!,')'lRes
Limited Energy/Comm
$ 63.00
$ 75.00
$125.00
$]63.00
$375.00
$ 50.00
-L $50.00 w..dJ
$69.00
$100.00
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OWNER INSTALLATION
The installation is being made on
property I 0\1'0 which is not intended
for sale, lease or rent.
Owners Signature:
$50.00
$50.00
$25.00
$45.00
I\Iinimum Electric Permit Inspection Fcc is 545.00 + S~II'chargcs
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4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Allministratiyc Fce
TOTAL