HomeMy WebLinkAboutPermit Electrical 2001-2-15
DEVELOPMENT SERVICES DEPARTMENT .
. ubmitled hes the lolloll'"n 225 FIFTH STREET
ihe lollowing prole~~e specifiC lend use SPRINGFIELD, OR 97477
zoning, 't!f".!!s(J'( (541) 726.3753
epproll'el J...tfl.::. .. ... PERMIT APPLICAfN(541) 726.3689
225 FIFTH STREET Zoning . "!.J>".MCAL nON
SPRINGFIELD, OREGON 97477 2--I~ ~ (_: <;
INSPECTION REQUEST: 726aai1J69 =r<;/ Cuy Job Number (7~ 0071lb~ 01
OFFICE: 726-3759 AUthOrized Signeture-
3. COMPLETE FEE SCHEDULE BELOW
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LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
116<)(")330
07g00
JOB DESCRIPTION /
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor .~ ~
Address 16 '{2- /~ ~
Ci ty ~,.,.,.Jl- Phone;rz?' -(Stfl.>
supe~visor~icense Number 11>- s
Expiration Date / Z - 0 Z--
Cons tr Con tr. Number 6 '5 ("') 7
Expiration Date
/2 - 01
Signature of Supervising Electrician
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V /' /1 (Ii D.
Owners Name(-, Ile..~~ r:-k.o-.-. ..MF-S 5:;....'-.
;--/, v '7' '7 7
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Phone '3f{)' - 'Sf" I
Address b z. cr '5 '7
Ci ty '"&-... 1..
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
---------------------------------------
DATE: t?2/~O f
RECEIPT 11:
RECEIVED BY: ~ rz
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Sum
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each (IGi1u~ Home or
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~o~
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 85.00
$ 15.00
Z-
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
see ItB" above
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.~
Limited Energy/Res $ 20.0:e:;.....:;::
Limited Energy/Comm $ 36.~~D
rn~
5. SUBTOTAL OF ABOVE ~~Jl1;
7% State Surcharge ef) No:lf-'
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3% Administrative Fee ~:~8
TOTAL -::):',.~~ ""
om. 0'::-'
0"rt100t.1l
Jo...-L..O~""""
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit