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HomeMy WebLinkAboutPermit Electrical 2002-9-13 r 1) . ELECTRICAL PERMIT APPLICATION City Job Number C) '2 -0 / / 0 I -0 I 225 FIFTII STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726.3759 L LOCATION OF INSTALLATION I 010 ~ O~ 'N\.1.ll'" J...o I~ A._tl.e:-v ~sjdentialZSingle.or,..n ,,',: . ~;T'''. .';"= ~ -. T I'~..n. -~'t:.,:~'."~~4__~,!,,~r:~:":"~:~~~: :':.~!f'~:~:'t.. ';.I~:'{ : <.I.:.' ~t ;d"\-J" MUlti~Fariii1yper dw~ning~~t.'71..-,;/ 'LE"OALDES'CRIPTIQ&"""" -'-' .,.,."".,......,..,. "S,.r_'~.I"'I' ,I" ",_ ,: '.'!, '., '. /:70;J;J;"4 c.. L.-f.. 05'~Ob" -~, .c,.. elVlce. nc uded: "-,c", ....._-~_. . ....... - '. . t ssuom1tl6uhasthefollOwing Items Cost Sum Tile follOWing prolge. a . acitic land use JOB DESCRlPTIONng. and does not require sp 1000 sq.ft. or less $106.00 _, t'U,"O-. 0 .QtPf~~ 1.J:2f]- 1"och additional 500 Zoning q __ "" -\7-- sq. ft or portion Permits are non-~e,,,,hl. ond eXjlire . tf\ 0 thereof $ 19.00 if work is not started withi2 !!I8Pllilm. . t &.ch Manufd Home or of issuance or if W31'1r?JI~:kpended for Modular Dwelling 180 days. Service or Feeder $ 50.00 3. COMPLETE FEE SCHEDULE BELOW 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations or Relocation: Electrical Contractor_IJIEGDN GD~:~ SERVlf1. Address Po ~Ol{<9~9':l "\', ,Constr Contr. Number _~~oo I 200 amps or less $ 63.00 201 amps to 400 amps $ 75.00 401 amps to 600 amps $125.00 601 amps to 1000 amps $163.00 Over 1000 arnpslvolts _ $375.00 _ ~OlU~~onnect ~ttEXPIRE if '\'HE ~ $ 50.00_ lHIS PER::Elt~rW!~e~RMIT IS NOT '1\.tref~~A~~ fOR CAN'Y 111n nA,Y P&RIOIl. '2M"amps or less 20 I amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts see llBIl above $50.00 $69.00 $100.00 - City _r ~~ ~hone Rl.t,~ (Ie ~ ( Supervisor Li~se Numb~ I ~q~...::s . Expiration Date ". /0 - I - oc.j Expi;"tion Date ~ - (It - 0 '-t Signature of Supervising Electrician -Z1 AN>VJA. ~ (109-.. / Owners Nam~ 1M...... D. Branch Circuits l:90:mIHS\!:J' : 39N\!H:J ~L'l:~ $ G:a:J3~ lW\! GOOG ~l: d3S:31\!O 96~Ol:OO-l:O:#SN\!~1 N AI . E'''''''PU\p.O P I ew, terattonlm\' xtenslOn'\ ,er ane n \I:1Vl< . On u\. . 'J ON"orego \\'Ie orag e\ \01'\\'1 t..J A ~ Address ~ l\tn::,~'\ One.c;liratii'J r"\eS are S5'2 0ni:.L $43.00 ~ ~ " leS ",,"v, ,\'lOSe'" p.fl, 9 . ':11101J11 rU Gq(\\et. "Mn'lf\\'IO "" ,.,laS '0'1 Cilv Phone ll.f-"") E'-"O!\\',\'lca\iO" Each-AdditioiiliLCircuitor'witli,Service ~~ '20\)'-"'''' n<n\\1"'" ~O'\J OWNER INSTALLATION ,~ Op.fl, 95 'or F'US"r,.P.efinit '\\'I3\e1e?, \ioO-.-- $ 3.00 _ 1(\ '101.1 f(\a'1 r ~tI\o\e., ~o\illca Th ' stall' . b . d 00911 Mi"- 11"p'(\\e ('S --l~uh\\ld ,. I ded) em ationls e1ngma eon ro\\..;;..sce ~~}lf{ .SM....;'J.~~S't.Il~tmcu property I own which is not intended C f(\\:)er Ic-Each iIllit@atio~~ for sale, lease or rent (\1.1 CPiiinp b1 irrigation Sign/Outline Lightine Limited EnergylRes Limited Energy/Comm / Owners Signature: $50.00 $50.00 $25.00 $45.00 ~ 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee 1../ ~ C-'O ..3 '& _~ lc>'O TOTAL .;s I :J.s