HomeMy WebLinkAboutPermit Electrical 2000-7-6
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225 FIFTH STREET "1"'''01) I S",90'''9S ,ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9747''''.0',' 9,,% jI'./at,
INSPECTION REQUEST: 726-37fJ1t"o,,, ""O',,;O~ty J()b NumberCO-OIOLf'7-:0 (
OFFICE: 726-3759 ~ 9
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1. LOCATIOli OF INSTALLA}'ION
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JOB DESCRIPTION - .
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Permits are non-tr nsferable and explre
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
-;
Supervisor License Number
Expiration Date
/1;702..
Constr Contr. Number
~
I
te
iU~~~Electrician_
---- -,......, '------
Owners Name Ibllr.; Ld7f({7''/A~
Address p, 0, /l;;)f 1F.'5
Ci ty -Lx 101 fe.tv! it e.. Phone ..H11- Fj :j1~l
Si
OVNER INSTALLATION
The installation is being made on
property I own ~hich is not intended
for sale, lease or rent.
OIffiers Signature:
---------------------------------------
DATE: 0"70~OU
RECEIPT j1: '2-,-/'-{ 7
RECEIVED BY: ,,,,K
Residential-Single or
lti-Family per dwelling unit.
Service Included:
Sum
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
$ 85.00
$ 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
D.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
--....
Branch Circuits
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
(\ .' . Installation, Alterations
Electrical Contracto~lV/f\lb"rL ~ Iv/o.JrOIUoQ 11il.9r Relocation:
, I
Address PD. (lmx 1./054<{ ,200 amps or less
I 201 amps to 400 amps
Ci ty r;'N9111L.- Phone2..<I/- 4'6431!7-'6 401 amps to. 600 amps
601 amps to 1000 amps
?j?J?;7 J"-G" Over 1000 amps/volts
Reconnect Only
$ 40.00
S 55.00
$ 80.00
see liB" above
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ~ith Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
40.00
40.00
20.00
36.00
$
$
$
$
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