HomeMy WebLinkAboutPermit Electrical 2001-11-16
I' Itf IOllowmQ project 8S submitted has the fo"o~in,i - - ---
ZOnlng,~and does not require specific land use A
appro v
225r'rJn STREET ning L-m.J: ELE PERMIT APPLICATION
~~~~::uif~ ~::~:'v; I \~~~! J I N' Cill' J~b Number CJ (- 0 1/ gb -0 I
OFfICE: 726-37~9 Authorized Signature 1) ~G ,
3. COMPLETJ!FEE SCHEDULE BELOW
I. LOCATI01:iPFINSTALLATtON '
~/Vtl{!,('-:J6T IJVAV A. NewResidential-Sillg1eor
, LtL ,p,),) Multi-FarnilypcrdweUingnnil.
LEGAL DESCRIPTION, SeIVice Included:
/g-O:3,03( Ol./l...cra ' ,Items Cost Sum
2. CONTRACTOR INSTALLATION ON!. Y B: Services or Feeders
L /) Jl I I. lnsta1Jation, Alterations or
Electrical Contractor ,,,. LJ f( ll-iJn /'Ii?} I IN L. Relocation:
Ad~essr;8 W, '11" ~ht.6Gl
Ci~P / / tJ 17lf7 Phone 7tf7 '~('3J
Supervisor Ucense Number / '-17 5 s
to/O/ loti
,
Constr Contr. Numbor gt;99
L"I,;.o';on Date 12/1 J' /0 L
I
JFZJ;14
J@DESrnzlIOlt h J, '
,~~TIt Cf Tf IVC FIJ ~ 7l/.1</J
/fI(OUIVD, ,
Permits are non-transferable and expire
if work is not Slaned within 180 days
of issuance or if worle i$ mpended for
180 days.
Expiration Date
...,..."...
1000 sq ,ft or less
EaclL additional 500
sq, ft or ponion
thereof,
Each Manufd Home or
Modular Dwelling
Senic. or Feeder
$106.00
$ 19.00
$ 50.00
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 ampslvolts
Reconnect Only
, O{!)
~$63.00 63;
$ 75.00
S125,OO
$163.00
$375.00
$ 50.00
C. Temporary Services or Fe.eders
Installation, Alteration or Relocation
Signature of Supervising Electrician
~~ ;/ ~~~
OMlers Name t{/ t /IJ I s.h
Address 5(0) FRfl-Nldl-n I3tvD,
r.._. cpL/O'?::>
Cily tAA4l f/J... , Phonc
o\iJNElR INSTALLATION
200 amps or less
201 amps to 400 BIllpS
Over 40 I to 600 amps
Over 600 amps or 1000 volts see
liB II abo"'"e
$50,00
$69.00
$100,00
D, Branch Circuits
New Alter:ltion or E~'ension Per Panel
E. Miscellaneous rSel'ic-elfetdcr not inchuledl
-Each installation
Pump or irrigation
Sign/OuTline Lighting
Limited EnergylRes
Limited Energy/Comm
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owuers Signature:
One Circuit
$43.00
Each Additio.uaI Circuit or wiTh. Service tJO
or Feeder Permit -L $ 3.00 l.........
$50,00
$50,00
$25,00
$45.00
1:90:~mHS\:J::l
: 39N\1H::l
06'gL $ Z:a::l3~ 1W\:J
1:00Z gZ 1::l0:31\10
1:60LOOO-1:0:ttSN\:J~1
Minimllm Electric Pcrmit ln5pection Fee is $45,00 + Surchar~es
/ 00
01() ,
dB
5, SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fce
TOTAL
-10 or (
.
PAY TO THE ORDER OF
. SPRINGFIELD BRANCH
US NATIONAL BANK OF OREGON
,FOR DEPOSIT ONLY 1 536 0145 2508
CITY OF SPRINGFIELD
DEVELOPMENT SERVICES DEPARTMENT
OCT 25 2001/75.90/01-0007091