HomeMy WebLinkAboutPermit Electrical 2001-12-17
-I
T~e. following project as submitted has the following
zonIng, and does not require specific land use
approval. .
Zoning' . ~D~
Date ' \')-.\ l'11 0' ELECTRICAL PERMIT APPLICATION
91.{jJ]_ri~ed..Signature 1)1/. no. - J 760 0 I
..i2'r: :,W:J ~ City Job Number (')/-00 :..
3. COMPLETE FEE SCHEDULE BELO\l
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION OF INSTALLATION I
76" ~ (J / r ( CJ,c.- t.. /l<t.- -J..
LEGAL DESCRIPTION
170"<., 2J,4'~ 02(02
JOB DJ;;SCRIPTION
jf",....s c.- wi fL r::
Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance ot if york is suspended for
180 days. .
A. Nev Residential-Single or
Multi-Family per dvelling
Service Included:
1000 sq.ft. or less
Each additional '500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dvelling
Service or Feeder
Items
uni t.
Cost Sum
$ 85.00 g~"-
$ 15.00 (;0
.$ 40.00
(
1-(
2. CONTRACTOR INSTALLATION ONLY .n. Services'or Feeders
)' E j . Installation, Alterations
Electrical Contractor _ ~ E (Qc.'+-{\~ ~r Relocation:
Address ASDtl{ <;p..eoM'ecJlD.Ll.'JuJ I~d
City 7'J'fOflQ Phone (M~ -~Lf9~
Supervisor License Number Lf(7t..f - 5
Expiration Date (0/' / 2.003'
I C.
Constr Contr. Number 1054'15
Expiration Date 3/1/0';;/
Address
I ~7C{
City
Pv &L-A!'(/ Phone
O\INER INSTALLATION
The .installation is being made on
property I ovp. vhich is not intended
for sale, lease or rent.
T90.~Ovners Signature:
, . ajlH;:'OJ
: 39NlJH8
~5~~S~~iaF3~lJi~~7~~3-~/------=-~-----~
96i:l.OiilicE1::P.TJI'lFM I '-' 7 - , 'l-<, -/ 6
RECEIVED BY: ''j){( , -
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Branch Circuits
.'
Ney, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
Signature of Supervising Electrician
~Q [)~
Oyners Name -:.s-/~ ~Sc.(.,,",- h~L~'
Cob~~c; ~c! -ttZ'f<-(
7
/..,1; I{ - 't,'1l( F
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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