HomeMy WebLinkAboutPermit Electrical 1999-1-28
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Th<tOliowing project a . -
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225 FIFTH STREET "~~Iuval OIre specific land use ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonlog. .l....DI2-' ~,C}
INSPECTION REQUEST: 7Qhe3769 /-i)..'? -44 '::ity Job Nwnber 'i q 00 g (
OFFICE: 726-37S9
1.
?"",otlzaa Signature _<X...J 3.
LOCATION OF INSTALLATION __
3 '1(,,3 ;t!o.eTfI 5Te{.~
LEGAL DESCRIPTION
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,
.A;:; JOB DEScrpION "]
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Perfr(~t~t~~~ non-transferable and expire
if_~ork is not started within 180 days
of 'is'Su~H~'eT SHAH [vift*E~1> l~!LS'WJ)?~d for
180, lday,~:iZEf) UNDER THIS PERMIT Ie:- ;.' , ,-
2.l~~NTRACTORli:NSTALLATIP7N O~ '
. ~ li1:;""',
Electrical Contractor
Address ~ / '
Ci ty Y Phone
Supervisor Li~nse ~er
EXPirat~Date ~
~
~
xpiration Date
. "
Signature of Supervising Electrician
Owners Name 5/ (/2Il4 f?U/L 0 ~ 8. S
Address 8"3 1<f3 f3ju~PelS~ eo
Ci ty Cl!f.Sc.u~L-L Phone ?f"t-j-8,).{pt;
OWER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Own~redlL .
D~TE~/-~----~:~lf2J-------------------
RECEIPT i? (')';>.;)79 "I
RECEIVED BY: /'.) _ /YIrvl1./7 r;)('.I- ( I
COMPLETE FEE SCHEDULE BELOV
. A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items
Cost
Sum
$ 8S.00
1000 sq.ft, or less
Each additional SOO
sq. ft1:\"'Nnortion " ,
ther Aifu'l: ",vl'r.'\Jregon law reqU$'efS'%OO
EaCh~~~\1~~~e~~ 8~~Pb~ 1:., ,1'0 ;Jregon Utility
Mod rO i\lli;'l 'PEl r.'those rules are set forth
ser~ ~ ~ Illr 10throughQ$P4'0VOO01-
U u. ou may obtain c;ufJles of the rules by
Servi c@lIiBl1tfFeea~!@.l. (Note: the telephone
Ins taf1j!~nqr WIH.QitatJ:l'"onlility Notification
or Reloca t ilOmter is 1-800-332-2344).
Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00 ~ en
$ SS.OO
$ 80.00
see "BIt above
,B.
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
C.
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
$ SO.OO
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
/
"
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
S.
SUBTOTAL OF ABOVE
S% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
40.00
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