HomeMy WebLinkAboutPermit Electrical 1999-8-18
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
~S<( 3.
1 LOCATION OF INSTALLATION
86t) .:; ~- -:: f)1n! /Jr'-;th.a...& Ldr?!:..rT€NA/OI\JNew Residential-Single or
iii' i'OwrUlesa~allililIlF&\'VMY ,per dwelling uni t.
/-7f;Af, 1~~rYJ-ltJOO {~~%~~~~~50~note~~~~~~6~g::~t~fto Items Cos t
VV1:1V. You - 010th eSares y
JOB DESCRIPTION Calling thmay O,~Of),fI c58~!f10ASt9~lgrth
C; (I' II r i -I-u 7 1/ rYJI '/ " d .,.. n , Y pllp1her forethcenBa.'lI'J( i~!PtftWQ.~IU?e~&bl-
, , ee eOr~~on :,)', .oi1tlflepMon Y
Permi ts are non-transferable and expire .merls 1-~linr, lo;#tYNotifiCRt?e
if york is no t started vi thin 180 days Ea~Ii-'&h'il'f-/41 !fonte-nor
of issuance or if york is suspended for Modular'Dvelling
180 days, Service or Feeder
ELECTRICAL PERMIT APPLICATION
City Job Number q9 {)'1- 7 7-
COMPLETE FEE SCHEDULE BELOY
Sum
$ 85,00
$ 15.00
.$ 40,00
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
'. . Installation, Alterations
Electrical Contractor,O;,Nt"Y1/!,d f. 0I-ron'~ Relocation:
Address /J.O, 11/)>o' <1/)5"<;( . 200 amps or less . $ 50.00
~: 201 amps to 400 amps $ 60.00
City? "9LL" Phone 5'<11- &.67'6 401 amI's t0600 amps $100.00
ISP1: 601 amps to 1000 amps $130,00
Supel-visor License Number 3q341untJ rrSHAU~r;,)'QQO amps/volts $300.00
C 0 UNDE~~c.6.rthlFcTHfl~R" $ 40.00
Expiration Date Ip /.:Lq OMM~/yCf:D()D IH/SPERMlTI.C::~'''''
(' ANY 180 "'{;..ISAaz\Jll'J'hli~~' 'S~~ces or Feeders
Constr Contr. Numbfr qg'14~ DAYPERIOD,InsfiilTa~liGR Alteration or Relocation
ion Date /lIon 200 amps"or less $ 40.00
~u1 amps to 400 amps $ 55.00
ectrician Over 401 to 600 amps $ 80.00
Over 600 amps Ol' 1000 vol ts see "B" above
Name~r" A ~Ofl1.1~
Address P /). An". 7s1z5
Ci ty f. L/f'LLl.' Phone 1/1" - Zt, /, 0
OYNER INSTALLATION
The installation is being made on
property I ovp. which is not intended
for sale, lease or rent,
Ovners Signature:
---------------------------------------
DATE: ~-\'fs'-_"'I '\
RECEIPT U: O!>~ ~<
RECEIVED BY: .
D.
Branch Circuits
.'
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included
-Each installation
Pump or irrigation $ 40,00
Sign/Outline Lighting $ 40.00
Limi ted Energy/Res ----L..- $ 20.00 ?O:7>o
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL
? 0,00
J,&/O
. 1110
/J'1.0,o