HomeMy WebLinkAboutPermit Electrical 1999-1-4
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
ELECTRICAL PERMIT MpLICATION
Ci ty Job Number U. ~ \[05
COMPLETE FEE SCHEDULE BELOY
3.
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
/ () - n I - b~rI7''''1i"'
. .. . .-..: C. Temporary Services or Feeders
Cons tr Con tr. Number 1. 0 - ~.)-j!fe.S PERMIT SHALIns talla t ion , Alteration or Relocation
AUTHOR L EXPIRE IF TJ../
Expiration Date JD- 0/ - '5':1-. IZEDUNDE+P9H~p.s"0t'E~~f1srK $ 40.00
. ,/vlVI/VltNCEDOR ~201 limP'iiRit'i>;,~W?Oamps $ 55.00
S~'gn a~ oJ Supprvis:ing Electri~ta,n,." tov'ii'NINJ,'+:EEP..:r?OO anips $ 80.00
. d. . Il2- _ . r .I,y PFRln{Jver 600 amps'1or 1000 volts see "B" above
U.J.R~r1'9 .:t4/~ '
. - ' ~ L~. _0. tlL..._ D. Branch Circui ts
Owners Name~ 1..4UJ.' ~on
t\L\ f\, MIle::: New, Alteration or Extension Per Panel
Addressj1J n~' U/.~
C. MAn J.f) One Circuit $ 35.00
CitY~leJ\.J--.- phone.:.LI:t:7.t~ Each Addi tional
Circuit or with Service
OYNER STALLATION or Feeder Permit
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
l'
~~~4CJ:)
JOp...DE~\gYON fl rvt~ 1000 sQ. ft. or less
~ 'i;- ~ 0 ~~~ 0 f'("~ CV LJ-\ Each addi tional 500
. A NTI'J.N:OregoIi5ltwtJ ~f .,p,ortion ~
Permi ts are non-transferable ancfobphl~S adopte?f: ~ngi e. yo~ ~o ,
if work is not started wi thin Nillifidlllllin Center t~1i M H'a~r,\l41iYhle or
of issuance or if work is suspim~ IJYl:00t-OO'1O ~IfJ~lri' lfj'tlMtl/fYl
180 days. 0090. You may obtai e~<JA6\:9!Fel!aer
calling the cellter. ~~~I,~~~~ t~n~~~~by
2. . CONTRACTOR INSTALLATION ONL'llumber for the\) S~'rV~<;:eselHf"",..-uers
/J /..-. C ,reQtmNlia.ty.N.qtK~!ltit'll1'terations
Electrical Contractor /JtJA h~{,..b- blo~B{'S 1-88\l-~:O'Mi1Uion:
Address1$U ;(lJ<.7 ~tu'/ 'f n lJe-- 200 amps or less
f 201 amps to 400 amps
Ci ty r \/'1 """'- Phone tt:>~'7 7r13 401 amps to. 600 amps
601 amps to 1000 amps
~ '7 7.;-5 Over 1000 amps/volts
Reconnect Only
Supervisor License Number
Expiration Date
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Owners Signature:
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
-----------7--
DATE: -
RECEtPT II:
RECEIVED BY:
---~7T------
~A~\
'r A /
Items
Cost Sum
$ 85.00 P>~
$ 15.00 15
.$ 40.00
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
"
$
2.00
no t included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
J~.C()
-~cm
.M:.A' . "'\'-L