HomeMy WebLinkAboutPermit Electrical 2002-7-1
1. LOCATION OF INSTALLATION,
...,t::.<J. 'r.,( ,,1.' (J... C kcv- &... : - A, Nell' RcsidcntiaI-Single or
7 ") ')3 ,-".J () a ~ Multi-Family per dwelling unit.
LEGAL DESCRll'TION I 0:> CI ( ::> 0 Scn'ice Included:
L-o-t- 1'2., Q..,,---~~ S~ ~e\<~
JOB DESCRIPTION \o\\O",ing
LDw VolfruJe-/I.-.~'^~J. &,..v"'.....tI\'I3sl\eno "s.
" sut:tnl" c"\C a
'.etaS ',e s?e
'p.'O\ ~Q"\
Permits me non-tr\I\lI'lf6i\\\\al':..;Il1dQ!,.!prre thereof
if work is not s\\;IIllt,VI'/IlinI80 da)'s Each Manui'd Home or
of issuance or ifa\lll'I'l1'~ ~1i\\1"\l r_~"1- .Iodular Dwelling
180 da)'s, 0 (] /' I Service or Feeder
2, CONTRAcT6lt;m~J~!\"I'llSN <;JNL Y B, Senices or Feeders
, . ,_'1 ~ f. ~-:P:-~~~.o ,-~jl .'. :,-(,' Installation, Alterations or
'Elei:,irii::ilI=.OJ1l.ractor'O'('cL~fe.'la:,s IN C Relocation:
I \, I' - 1,' ,',-., .... "",,", .... . " t'i" ", _
'r) "_" ,', '[~'~'~l" ,.' -:fJ:1. ~ ~.- ./',
~t,\<!dress, V\l.>,~"'-W':l' '11::1~,',-
.. ~" '., r,' ~,;" L-:...l).-'
~C;~,'9A'~';~.~'? Phane; Lff<;'G 000
-"-I ,
200 amps or les; $ 63,00
201 amps to 400 amps $ 75,00
40 I mnps to 600 amps $125,00
601 amps to 1000 amps $163,00
O'J:\lQll,O amps/volts _ $375,00 _
OOad~t Ontv $ 50,00
THIS PERMIT SHALL EXPIRE IF1'fitWOHI\ -,
r-l c;" Te'AAYTMO~iH6NeEthtldIS PERMIT IS NOT ,
C>...~ InsetwiN1E~D'0W IS JUIA#Il6}NED fOR
CtL ~ (l/ A~~01,~~Po~~efsERIOD. _ $50,00
- - ~ 20 I amps to 400 amps $69,00
- Over 40] to 600 amps $]00,00
Over 600 amps or 1000 volts see
"B" nbove
.
225 FIFTH STREET -
SPRINGFIELD, OREGON 97477
, INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
. :
'! ,I
Supervis,or Licens,e Number
Expirat~on Date
i"Constr Contr. Number
I 2 ')7 3(.
, Expiration Date
& - 9 -03
Signature of Supervising Electrician
rJ/l(P/~~,
EL.1CAL PEMlIT APPLICATION
" ~aa'\\1J009799
CityJoh Numher!).] -(ln76nr/fE:Qt 01 2002
AMT RECD:1 $ 60.00
CHANGE:$ 8.25
CASHIER: 001
'3, COMPLETE FEE SCHEDULE BELOW
Items Cost
Sum
1000 sq.fl. or less
Each additional 500
sq, ft or portion
$106,00
$ 19,00
$ 50,00
.., "
,(, /L D, B,!!ll'Ch Circuits ,
Owuers Nllmr{}:]i6./ _~J,q.J U::,J'J) Ncw Alteration or Extension Per Panel
" ,
Addres5 '?(E'~ ~Cj ,<;~ 2-
Cit{3UGr-,rlJ6 D~one 403 -i (Joe)
,f
OWNER INSTALLATION
The installation is being made on
property I 0\\'11 which is not intended
for sale, lease or rent.
Owners Signature:
One Circuit $43,00
Each Additional Circuit or with Service
or Feeder Permit $ 3,00
E, l\liscell:meous (Service/feeder not included)
-Each installation
Pump 'or irrigation
Sign/Outline Lighting
Limiled EnergylRes
Limited Energy/Col11111
IoU ljl/"w..,,'
I\1 inimum Electric Permit Inspection Fec is S45,()() + Surcharges
4, SUBTOTAL OF ABOVE 46,01)
70/0 State Surcharge
8'Yo Administrative Fce
$50,00
~5(),OO_
_ $25,00_
$45,00
TOTAL
0-/.7-)