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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