HomeMy WebLinkAboutPermit Electrical 8-6-11
i..
225 ~IFTrr STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Permits are non-transferable and expi~2
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number 10? 'S fiS
Expiratio11 Date lo-/-CJ'i!
Constr Contr. Number
Expiration Date
. Signature of Supervising Electrician
gl,.L A~~
wne s ~(,)~ (~J:'[lO s.c\.-.c>o\.~u~ 19 D.
/ v' 1."'
Address '-./ /<2CfD ;V. 1.1 ~
Ci ty <;/~ IlIrA eL:j;> Phone1#-C.37~
OYNER INSTALLATION /
The installation is being made on
property I own which ~s not intended
for sale, lease or rent.
Owners Signature:
;/ I .
~111iL /~. ...
~~~;:J1~C:~=;~---------------
RECEIVED BY: /J . /YlB>(j1t &f{)
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
ModularDwelli~g
Service or Feeder
B. Services or Feeders
Installation,-Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items
Cost
Sum
, . - .'
NOT\CE: EXPIRE IF THE WORK :
TH~S PERMIT SHAL~R THIS PERMIT IS NOT
AUT~ORIZE~ UNO ~(j;),,~loIlowlng
COM~E~OO requtre spec:lftc ~LECTRICAL PERMIT APPLICATION
9 iR'fR~~'t1~ y P ,41 . V
'j26-3769Zoning 1.J.-; , Ci ty Job Number q 3' 0 55$1
Datel ~1I....q {'
~. 3 COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLA~ SIgnatUre (\ ",,' ~
:l.3SS YOLAN/)A ~. . A.
LEGAL DESCRIPTION /7GB dL/ /.100.;1/ t5U
;51f(q9-~ /Yj II)})/€:. Sr.).. DO L
JOB DESCRIPTION
,,~eAD~ ~OAJl,.U
$ 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
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
,.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00 35~
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting---L $ 40.00 ,/O~
Limited Energy/Res $ 20.00
Limited En~rgy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL '
7_01\
~-
~ .75
:J. . ::i s
f(/ . OD