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HomeMy WebLinkAboutPermit Electrical 2001-12-20 . "'-. ELEaCAL PERMIT APPLICA nON ";' h N' I 0/-' 0" 347 TaaN:.:" 01-0007592 CIty Jo : um lcr ' -3:'\'(E: DEC 20 2001 ffilT RECD:2 $ 77.05 CHANGE: CASHIER: 011 , , ' , 3. COtvlPLETE FEE SCHEDULE BELOW l.LOcATIONOFINSTALLATlO.l", i ,; ., '3 S ~ 0 OL y' m.p) (. ~ 1t]'-SPFW.- A. Ncw Rc~idcnti;t1-Single or ~Hloylil'~i1y pcr dwelling unit. LEGAL DESCRIPTION I q -J l>",i\\.O\la~~C'~'ncluded: 11. O'J.. .30 .00 ;;L I 'g\eel as s~\lil. s~.e' Items \oIlO'lll\lg d~.s \101 I. . ~\le .\10 . JOjl DES<;RlPTlON n <"I"I'\) \ 00 S ~ CA.A.r ..lA..l:r;;.."~\,,.a l;n\NI ...0 \ ,1 addltio \'1-- ~ portiou Permils are non-transferable and eX8~t(; , ' ~\l'" thereof if work is n?t started within 180 days u'''-''o &~ Each Manufd Home or of issuance or if work is suspended felt"'" Modular Dwclling 180 days. Service or Feeder .. . 225, FIFTH ~TREET , - \ SPRINGFIELD, OREGO!'l9747? INSPECTION REQUEST: 726-3769 . I ., I OFFICE: 726-3759, " :; .. " ' \ ,i ,1, l ; ~ ~ : ._..1. ---:-1 2. CONTRACTOR INST ALLA])ON ONLY EIeClrical; COr;'J.~ctor H~/lrVl>1 EIe~ _', Address, !/o/lox, 9/7 /- City ~ ;(~I~J~j(Phone_{(n-Qtr7 " Supervisor Licen~~;NUll1ber ?/ [; C( 65 Expirali~n Date '; /6.- 0 ( - 0 c. / / I Lconstr<;:on~. Numbe,_7.0~c,;r1 (f . "Expiration Date '/0:--0/ ~o1. B. Services or Fccucrs 1nstanation, Alterations or Relocation: 200 amps or less 20 I amps to 400 amps 40 I amps to. 600 amps 60 I amps t6 1000 amps Over 10QO amps/,;olts Rcconheh Only C. Tcmporar)' Scrvices or Fceders Installation, Alteration or Relocation "'""71t:JJ71Jr; -------- 200 amps or less 20 I amps to 400 amps 'h '_Over 401 to 600 amps Over 600 ampsor"IOOO volts see "B" above "- "'"__ /\ I " D. Branch Circuits New Alteration orE'Xtension Per'Panel !,I/ \ I: j..j One Circuit !1 I V' Owners Namc c!l/f/f.t Lt=W mr.67Y , .\ Address '17iJ. fn1v..NEUJ)4 fW6 Cit)'-!:kNOLuLtJ I:!J.Phoric RD8 - '3 fS'-25Z5 I OWNER INSTALLATION The installation is being made on property I 0\\'0 which is not intended for sale, lease or rent. .~ , , .' Cost Sum $106.00 $ 19.00 $ 50.00 ~ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $50.00 $69.00 ---.:-. $100.00 \ $43.00 4'? Each Additional Circuit or with Sel}ice . or Feeder Permit ~ $ 3.00 I I E. Miscellaneous (Servicc/fccder' not included) , -Each installation 1'" "... " " Pnmp o,jrrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm Owners Signature: ;2L(cff) - ' " --.::. $50.00 $50.00 $25.00 $45.00 Minimum Elcctdc Permit Inspcction Fce is S45.00 + S~II'charges 4. SUBTOTAL OF ABOVE' 7% State Surchargc - 8% Administratiyc Fcc. TOTAL rb 7. cJ) i..f.r... '1 C:;. ok::, 77. OS-