HomeMy WebLinkAboutPermit Electrical 1999-10-5
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ATTENTION:J:::gc" ,aIM reC'~lra& }Ol' cv
follow rules adopted by the Orero'1 U!..iy
225 FIFTH STREET NQtificetion Centor. T'1C~" fu!aSt'rJ;!4.Q'FR:ICAL PERMIT APPLICATION
SPRINGFIELD, OREGONh9J'l'l'9"1'r.~ P~9J't9W.::.~:l"il,1""I)n'f1 ,',rOII(l:' OA:=l952-001- tje;IJ 3 '/
INSPECTION REQUEST.zon"l"'I!'~~'nOI'reqUlre'SRaclfIC lanu u.a C't ,T b N b
. 'app(d~IlTtlo:.;;'u. YOI' m~lJ,p,'1tam copies of th" "'~;))s-!.9 um er
OFFICE. 726-3759 II"na~"~cr INot-'lhpl-:10nhone
ZomrlQ'l' " ~ ~, . ~ _ -:':lWlJ:R'!;R :FEE SCHEDULE BELOY
1. LOCATION O~ INsw.LAp:.Q~um~.kSh;:'t:rO.:1 ~_I~T~~~L1Irr;a:iIUII
10)'f 171'/ /?ll.ddM!. L:/J t.,ei;~X"A~'-"'New"R~)sidential-Single or
" ... .-- ...f"-...o '. LI I~i-Family per dwelling uni t.
LEGAL DESCRIPTION V. Service Included:
/ 7 0 ~ ")."34<1' ()S"'ftJo Items Cos t Sum
2. CONTRACTOR INSTALLATION ONLY. .B. Services or Feeders
~ Installation, Alterations
Electrical Contractor . or Relocation:
Address ISPERMlTSHALL~1m=f~l~~os
/ AUTHORIZEDUNDERT~P~1 ~Nt\fo amps
Phone -oMtnENCEDORIS~~~FQR 600 amps
/ '^'. 6bT amps to 1000 amps
Supervisor Lice7nse Number ANY 180 DAY PERIOD. Over 1000 amps/volts
Reconnect Only
Expiration Date
Constr Contr~Number
E. . /D
xPlra?on . ate
Signature of Supervising Electrician
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JOB DESCRIPTION
Ilnt>AI/ AM-Ir...
:z c./IZ.C.... ,15
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
City
Owners Name ~bb7l-T JlFr4,r
Address 1f):Z L{ 0/ ~ O/l.d,,"/ LA/
City_ 5/Jp/f) Phone '-1(,5-502'-
01lNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
~.I ,Y, 1!4r,
-------------~r.-----~-----------------
DATE: tOf ,( if 'i ~
RECEIPT 11:. (I 1t'1~ 1;1(,1) .
RECEIVED BY: M (,/ ()../
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps Or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
1 $ 35.00 3J-o<>
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
I
$
;l.
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
170"
2..5'1
I. ~ /
'I~. 70