HomeMy WebLinkAboutPermit Electrical 2002-3-6
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225 FIFTH ~TREET . \ 'YV'-&J: vf" .
SPRINGFIELD, OREGON 97477 ; .(l.<A1 , :. '.", '
INSPECTIONRE9UEST: 7~6-3769 :-171$; . ,Ci\YJ~Mt\l!llllnt 02-00Z52-0 I
OFFICE: 726-3759! "! ,;' I '___, I; ",i\\eO,neS ~oo use
I . ',.". : i :; ;o\eeI3\S ~~~ FEE SCHEDULE BELOW
. [ I. LOCAT'ON.QFIN~1AL~;\WtjJl\P"\0~Xoes~?\,e, " I
7S'R ,., UA'-~d.4..Ie- ior/#'r.'" - --, A. M., ential~Si r ,., - " --, - '
e9PIU'- 7.00i09 _ 0 ~- amil)' dwelling unit.
LEGAL DESCRIPTION ~- " e .' uded:
/703 Z '23/ tJ UP . \Ufe Items Cost
, . eO S,goe
~I.l\notll.
JOB DESCRlPTION f.:) 1000 sq,ft. or less
{2..0c?..A--h":""" .B'i,k,r;/~ Each additional 500
, Vo;;OW rUle;'V:vregO sq. ft or portion
Permits arc non-transferabl,e/a!,dC'eXpu.c; C actoPtect fllaw re thereof
if work is not 'started WitQ.iD.9~a13<.>, enter. 7n by the oqY!aar wrnufd Home or /
of Issuance or if work is su~~n?tq,loln 007-0070 OSe rUle r~wdj;(~lIing I
180 days. nailing th ay Obta' throUgh OS ~~t {{{l4Jeeder
. ,/In/ber fn e Cente In COPie ~R 95: fOrth ,
2. CONTRACTOR INSTALLA:r-~O'iJ~%: (NOtdhh~(1~"rp,f~aers ,
, . I .nter;s 7, '!JonUtit ete/elfflr:.fi~tbyt, Allerations or
Electrical Contractor 800'33<.>,/ty NOtilnfRl?li'tion: j
, " 2344. at/On .
( ! /'o 'I. /
\ / . 200 amps or less
. ' r: r 201 amps to 400 amps
Citv . I Phone 1.// 401 amps to.,600 amps
\ ~,/ '601 amps t6 1000 amps
SupefVlsor License Nu , Over 1000 amps/I'olls
. I 0
. .' M Reconnect nIy
Expiration Date /' . 'Or,,,, '
/ / ' H4s' ~: C. Temporaf)' Services or Feeders
'- Constr Con(( Number I/U'1',?, ~RIJ1,'r Inst:lIlation, Alleration or Relocation
'- ' -- -----goit. URllt, Sltl/ .
~'E".pira(ion Date 4t'}> 1Wf.'Nc: Ol/ifu !L f-r,o 200 amps or less
.' ..' '80 1:00.' 'I:;~li ~R.f IF 20 I amps to 400 amps
SIgnature of,~uper\'lSllIg Elec{;>,~t, 'R IS I/O HIS PElT. -l/fttfJb:f.OJ to 600 amps '
'-"" l?IOo '1NOn :4flr9~t!tUi9kamps 01:10~O volts see
, ",- . vNfO Fi/%'IVrJj\ ~~~- \
D. Branch Circuits ).
',.., I
Ncw'Alteration or Extension Per Panel
(' 'l \ I I
." )
Onie Circuit \ '
I
"
-'
ELACAL PEIlivnT APPLICA TI~~
\
"
Address :
i
Owners Name a r, <" ~;: d
w1 A:iL L~'-M'
I
Cil\' ~e Phone S;t.jlf- /6 ? ~
Address 420
Each Additional Circuit or with Service
or Feeder Pennit
OWNER INSTALLATION
The installation is being made on
property I o\vn which is not intended
for s.11e, lease or rent. '
!', \
E. Misccllaneous (Service/feeder not included)
, -Each installation
\' . '. "
': Pump or irrigation
Sign/Outline lighting
Limited EuergylRes
Limited Energy/Comm
~L:n2:r~~
, ,
Sum
$106.00
$ 19,00
$ 50,00
"
$63.00~
$ 75,00
$125.00
$163,00
$375,00
$ 50,00
$50.00
$69,00
$100.00
I
$43.00 Lf3
$ 3,00
~ $50.00
$50,00
$25,00
$45.00
l\linimum Electric Permit Inspection Fec is 545.00 + Surcharges
, \ ---
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4. SUBTOTAL OF ABOVE
7% State Surcharge
80/0 Administrative Fcc
TOTAL
3/'0
,Sou
-/ 7 S-
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