HomeMy WebLinkAboutPermit Electrical 2001-11-1
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T~'."jng projectes submitted has the following a.
225 FIFTH STilEET zo~nd does n~t req~ire spepific land, use EL&CAL PERlvIIT APPLlCA nON
SPRINGFIELD, oRE'8'B~V~~t;7;., JJf'Yl.J' , ..' i
INSPECTIONREQUfST: 72f;~~)\;\W'&IIOI J CityJohNumher 0 I-DOf,I'-{ ~6{
OFFICE: 7f?-3759 Date "., I i,I/,D',L! '
'. " " Auihorized Signetur.' D~r rnMPI FTF FEE SCHEDULE BELOW
1. LOCATlONOFIN~~ATION' i ,~ i' : '
7.%/;' /P!I,-JRrR " k:v\Ja..i7J~" - 'A. N~WRc~idcnti;II-Single or ,-, .
--' , Multi-Family per dwelling unit.
LEGAL DESCRIPTION Scn'ice Included:
/-ZO 'L ")6Z-3 0 DiaD Items Cost Sum
JOB DESCRIPTION ,. I
~'t.lll,'m,^ ~I~ b..l (OV\~
Permits arc non.transferable and expire
if work is not'slarted within 180 days
of issuance or if work is suspended for
180 days,
1000 sq. ft. or less
Each additional 500
sq, ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$106.00
$ 19,00
$ 50,00
2, CONTRACTOR INSTALLATION ONLY
, , " " ~~r -
Electncal'Contr\lctor 7 ..... Et.e. ,
. '\ ~ / ~
Address' :1-)0/ /5/=. lA/iEJ.?J/1ff7~. W)/ ~t;.200 amps or less"
/ 20 I amps to 400 amps
City .4;;/;/1- I.ke ' Phone <;?],573,Q3'f' 401 amps to, 600 amps
,/ 601 amps to 1000 amps
Supcrvisor Licensc~Number /7 1St... Over,lOqO amps/volts
, ' f Reconnect Only
EXPiratibn Date " 10/ DL ()L.(
< . ',37'"-7S'l-C-
"Constr Gontr. Number ' i I /, .} {'2- '
"'~'Expiration Da;~-~h'7 / ().,;)
, I I
B, Sen'iccs or Feedcrs
Installatiort, Alterations or
Rcloc{tl6n: '
$ 63.00
$ 75,00
$125.00
$163.00
$375,00
$ 50.00
C. Temporary Scrrices or Feeders
Installation, Alteration or Relocation'
"'-
200 amps or less
20 I amps to 400 amps
----_,Oy"r 401 to 600 amps
Ove[600 amps or !OOO volts see
"8" aboyc .. '-, ",,_
\
\
$50,00
$69,00
$100.00
(:["~"~ OD
OW/lersNamc -=H,vV\.bGil.-~ 1111~O D.
,1 '---
Address 20220
Cit):---l~A- (tr'h......
,
.-:;,[-./ ~71/
~~) b7/-/977
Branch Circuhs J
Ne\~'Alteration or Extension Per Panel
/ :'
On'e Circuit
$43,00
r/
Each Additional Circuit or with Service
or Feeder Pennit
$ 3,00
OWNER INSTALLATION
The installation is, being made on
property I o\vn which is not intended
for sale, lease or rent.
Owncl-s Signatul",c:
, .
E. Miscellaneous (SerriecJfeedcr not included)
-Each inshdlation' '
Pump 'ori'rrigatioh
Sign/Outline Lighting
Limited EnergyfRes
Limited Energy/Comm'
, $50.00
$50,00
$25,00
/' $45,00 3S..
~90 : ;>j:n ~""~
, ---, 'WJ
r'8'~' ". :l91.,'I-J""I
~ . :$;...1 wt'.J
09 ~:g $ G:a:BI! lW
T006 TO ^~N:31Ua
O~T' 000 TO' l',p' 1-1'"
':" (.1 ~ '. ~ ';f.J11VO_~
I\'1inimum Electric Permit Inspection Fcc is 545.00 + S~II'chargcs
TOTAL
LIS
'3~~
:f~
>17S-
4. SUBTO.TAL OF ABOVE
7% State Surcharge ,
8% Administrative Fee
.to~
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",,' ,'..,.. ,", The following project 8S submitted has Ihefollowing
lonlng, and'does not require specific land use " , SPRINGFIEW, OR 97477
approval. ,j , ~J NlA ( , ' (541) 726-3753
, Zonin I'OL M" FAXI541) 726-3689
225 nnn STREET 9 I o~. Tn ( :ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON P~7:- I "_ ' /,
INSPECTION REQUEST: AZt?e~631gnalure cay Job Number 01 004 I"/-O I
OFFICE: 726-3759
3, COMPLETE ,PEE SCHEDllLE BELOlI
')
" "
~ .)
1. LOCATION OF INSTALLATION
2'0<01 PIERU: P-".?_KwAy
LEGAL DESCRIPTION
/7() Z ;'02.3 c,-o (0-0
JOB DESCRIPTION
LOGA-t.. 2.90 7tZ4,,vi,.JG ('FNTF.e
Permits' are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
/
180 days.
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home Or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
, Installation, Alterations
Electrical Contractor (h/),fcl. Eih7tVU))uJ(, or Relocation:
, ),: Address /28/0 "./1: A//<./'C!et (VAY
, City f?o4//".cc{ Phone, 7U; z15-949/;'
Supervisor License Number 2.-8(;,5--5
(
Expiration Date /o/(,,/d
Constr Conn. Number ~G /9"-' C.
Expiration Date 7'2 Z 6_"3-
Signature of Supervising Electriciap.
'/a.v.JY ~Ff
Owners Name Sf7e<..J't T f}E<.IEil;P/rJeN!
Address /74(;0 SWm/LUi:"~w4V
/ -
City ,gbdJcd~, (J1.. Phone..7<1' Mr;,-zZtJZ
O';lNER, INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
l, )
','
DATE:
RECEIPT'll:
REcEIvED BY:
" r.7""
\-?I.//
Sum
$ 85_00
$ 15.00
$ 40.00
200 amps or less /2- $ 50_00 (,00 -
201 amps to 400 amps I $ 60.00' &1.'-
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts I $300.00 .,...--
}~l.)-
Reconnect Only $ 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
Branch Circui ts
D.
$ 40.00
$ 55.00
S 80,00
see "B" above
New, Alteracion or Extension Per Panel
One Circuit S 35,00
Each Addi tional
Circuit or with Service
or Feeder Permi t iJ:2:.. $ 2,00 348-
not included)
Miscellaneous (Service/feeder
-Each installacion
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limiced Energy/Comm
r,zE. ~-'"
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administracive Fee
TOTAL
E,
$ 40.00
$ 40.00 D
S 20.00 ..... \
/:4:-: ~~i
( Y4 .3')~1 1'.:1 ~ 8
40,r;/}.2 '" -; 'J"
H(J~OC)
. :-:-~ ~"o:JO
.I /47 B"[]'1iM?)l ~ ?,;
o...rn.........OL...j
..........Ot-Lc....J
5.
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