HomeMy WebLinkAboutPermit Electrical 2000-3-24
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AMT RECD:2 $ 220.00
CHANGE:
CASHIER: 059
ELECTRICAL PERKIT APPLICATION
"'ity Job Number Q<1.0Iiq]--ol
The following project as submitted has the following
zoning. and does not require specific land use
approval.
Zoning
GjyL....
225 FIFTH STREET Date ..", - 2l?- ~
SPRINGFIELD, OREGON 97477 ,
INSPECTION REQUEST: ~!'3"'9,gnature =K t.<.--'
OFFICE: 726-3759
1. LOCATI<jN OF INSTALLATION
IIQ.. 0 Z () (')~"I~
_,.LEGAL DESCRIPTION
JOB DE~f!IPTION
DJ(Jl~
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~'1717.IIKI", (~C.
Address.-bLQ.L~ ~ vdl.,J.r1
Ci ty L...pfl r\ Phone ~
Supervisor License Number ~}lDl~
Expiration Date J() -01 .vl
Constr Contr. Number_7 ()-L&t? (I_
Expiration Date
10 -()I- 00
Signature of Supervising Electrician
Owners
j'},.,,,,, /'1_ A...
Name .s<-<511l/tYt Ot tv: t~
7- :f- lS E=- . l~
4 (j' -S :L. I &4'
Address
City ~... 0
Phone
~
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: /' I. ~
RECEIPT II: ~ a I()U~
RECEIVED BY: /__ (\ /IV)/! ~
'-"/'-" '~-(f~
3. COMPLETE FEE SCHEDULE BELOII
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items
1000sq.ft. or less a4
Each additional 500
sq. ft or portion "
thereof - d. ~
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
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
Cos t -:to ~m
I .
$ 85.00 ~o
0.0-
.,0.
$ 15.00 ~
,$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5, SUBTOTAL OF ABOVE :200 ~
7% State Surcharge
3% Administrative Fee
TOTAL ~20<l"-
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