HomeMy WebLinkAboutPermit Electrical 2001-12-20
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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
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225, FIFTH ~TREET , - \
SPRINGFIELD, OREGO!'l9747?
INSPECTION REQUEST: 726-3769
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I OFFICE: 726-3759, " :; ..
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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;
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200 amps or less
20 I amps to 400 amps
'h '_Over 401 to 600 amps
Over 600 ampsor"IOOO volts see
"B" above "- "'"__
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D. Branch Circuits
New Alteration orE'Xtension Per'Panel
!,I/ \ I:
j..j
One Circuit
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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
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OWNER INSTALLATION
The installation is being made on
property I 0\\'0 which is not intended
for sale, lease or rent.
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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
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$43.00 4'?
Each Additional Circuit or with Sel}ice .
or Feeder Permit ~ $ 3.00
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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)
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--.::. $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)
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C:;. ok::,
77. OS-