HomeMy WebLinkAboutPermit Electrical 2002-8-21
JOB DESCRIPTIO,N The following project as submihed hmoO~.Ift>.vOOlless
ne I J) sP-f,I/: C ( ~~~~~~~re~uire SP!"i!~'1{lil/l\l'onal 500
Z' L ~ M',e..~ortlOn
Permits are non-transferable and expire omng.. _' "2- ,- (1lt:I~UI .
if work is not started within IS(l'llIll'" ~'2.' 0 \ ':'c:c". '4an',fd Home or
of issuance or if work is suspel~~~.ed Signature o/')h J Modular Dwelling
180 days. Service or Feeder
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OwiICrs Nam~ /e/1 /1.1 Ji; If(
AddressdJt17 O~O/0'
/ ..-'
Phone IJlJ t - ~ 7 Is
.,
225 FIFTH STREET ' \
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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J~gCATl~ OF INSTALLATION
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LEGAL DESCRIPTION
/,03)<; 4~ OoSD{)
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2. CONTRACTOR INSTALLATION ONLY
E'ectrical'contractor,l~.eljt S
AddiessiO M ..:JS'r;Q/1.. /.
foIlC2"':"1.!IL:-l~'Op:~~,'f~ wt~"::'Of"t~;<... ""
,I' mty{~~~ .T,:'PhOne'!a''1~s ,.,,1}) tj
I.: OAR 9.;> _ ,,,1, -oJ'.~ \,', 0l'Ol, rf.~.'r . .
O:SllI~<;tyiligrl\.-!C;:.7n_~~~w~1!>~~'1!!<1J '/ ~,-- ') i
calling "" ~~',. 0~' "''7}'' , ',' '.
Expiration.Date :J~:O'.";).~ ," .
...... ".......1 .PI ,I . _ ............... .
,: Constr C~nir. 'Number j1f1.<l'{, L/
Expirmion Date I /111'
. I
Signature of SUJlervising Electrician
OWNE N TALLATlON
The installation is being made on
property 1 own which is not intended
for snle. lease or rent.
Owners Signature:
ELE.CAL PERMIT APPLICATION
Citv Joh NllmheL)~ () og ~:~~~OL -'0010380
. ;"ilTE~lfG 21 2002
13. COMPLETE FEE SCHEDULE BELOW AHT RECD.2 ~ 144,90
CHANGE:
CASHIER:OOl
A. New Resi~cntial-Singlc or
l\1ulti-Famil)' pcr dwclling unit.
Scn'ice Includcd:
Items Cost Sum
$106.00
$ 19.00
$ 50.00
B. Sen'iccs or Fecders
Installation, Alterations or
Relocation:
200 amps or less ...1:..... $ 63.00 ~
201 amps to 400 amps $ 75.00
40 I amps to 600 amps $125.00
~JO~J,.~)PS to 1000 amps -'- $163.00 _
c!>~MljOOO amps/volts $375.00
. lPiIll.J.1rS!hMllb'DtYAll EXPIRE IF THI' '^'(,~~Ro.oo ==
AUTHORIZED UNDER THIS PERMIT IS NOT
c. lEfiMtfietlJSiEO'OO 95 1iffi~-MllONEO FOR
IJlNljllfa6'Illi\V'~W1rJu.Rc\oCatIolI
.
,
200 amps or less
20 I amps to 400 amps
" Over 40 I to 600 amps
Over 600 amps or 1000 valls see
"B" (Iboye .
$50.00
$69.00
$100.00
D. Branch Circuits
New AlIeration or Extension Per Panel
One Circuit
$43.00
Each Additional Circuit or with Service
or Fceder Permit
$ 3.00
E. Miscellaneous (Scrvicc/fccdcr not inclndcd)
-Each installation
. Pump 'or irrigation
Sign/Outline Lighting
Limiled Energy/Res
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
Minimum Elcctric PCI'mit Inspcction Fcc b S45.IHl + Surch:6D
4. SUBTOTAL OF ABOVE / 1~ '
7% State Surcharge 7 '8' L
8% Administralivc Fcc / IJ . Og
TOTAL
/L/4. 90