HomeMy WebLinkAboutPermit Electrical 1997-11-14 (2)
'.,
The. following project as .ubmittod h-, l~. -, .
zoning, and dOGS not require ';:'J.:.:i~ -; , . '.
approval. .' .- .
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225 . FIFTH STREET D.toJJ..:..../-Q: - q;i ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 AUlhorizedSignature-DM /)~
INSPE~ION~~Q~ST,:JS\:il,2J)4'-~.1(i.~."".,....~"",-"""",,,,",- . .m_.____Ci:tY'-Job Number ~I / to 35
OFFICE' 7263759' ........ ." '~4t.dl'" -..- "'~'~".,....'---=~~r'"
t,.,.",,:,,~"'f:r.l{ ~.::;~ , ;~~<!~:~.',~,j;f.,; 'J:'i:~t" f" ;J'::i,.",\.~l.\ :r~~~~-\tr?\"l.r:4.:~',"~~~.;P'.'.'" ,~~:'.~tD:'F:"'~~l;t:t.' ~}/".~" .~'\fi:e~t;~".~"',71'-,::\.!.",.\,
. .'4F..,,;,.~.' .;~~ri;;J\
,. "~''''..,<,__''',i~~;.'';' '" :.,.>'..;~~'I'1!:.~m':,," l..:'< ''1\",--'1:-.3:... 'GOHPLETE',FEE "SeHEDUl:.E'..BELOll~")l~' .,f.~""
t. LOCATION OF INSTALLATfO'if'-':'.i..I-.I." ..b:.....l-.~L...5\-:~:.:..r.~..lJ.~:.r" ,,~,!~',~'.t,;.~~\~~:r:t{~~~..:t~~':.,:.!:~Jt..:.~"jf:1I
'-h~l..\ \'C"\<'.I<E:...,'Y ",_ I--t u?</ A. New Residen tial-Single or
Multi-Family per dwelling unit.
Service Included:
.'
LEGAL jJESCRIPTION ,.., K1'\
no1.-?l~L. ()\"'"'VU
JOB DESCRIPTION
14."t;sQ. m~~_~. "'..... o.J
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical ContractorjQ~.~~
Address_PO f3Q>< ~~..,
., '
City (;,,",,,,,,,,,,,,,, .fR- Phone?LL~- I~
. Cl-Woa
Supervisor License Number ~~~~
Expiration Date In - t - q<;('
Cons t r Con t r. Number .'::;,)< CJt'J I
Expi ra t ion Da te C\ - 14 - CJn
Sign1ture of Supervising Electrician
7lsur~/ (9&/
~"i t:ifl,.~ E).:)E:lCG>''r'
O....mers Name \1'\("IAC"I~
Address \)n ~ (oQ'J
Ci tyl,)tlS'o^~/' fIg. Phone.I-'ROO-,=>,I,,'1-3<iS.3S
vrc: o,?D?D
OllNER INSTALLATION
!
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: 14
RECEIPT 11:
RECEIVED BY:
~~~
'2.9iClZ-f
~
IS <17
/'_....~
1000sq.ft. o~~ess
Each additiOFft~~O
sq. ft o'Yoi~;}(15l~
thereotJ ~_ {(';Sl "
Each bW1~ ~ 1..112m~l"jlr
Mod~~1t"f-;D~J~ U'k
semce~_~~~ ~/
. ""k Q ~~.~
Services or p~~ '9~_ ~
Installation, ~eJl1e>jifU1.a~-1<- .
or Relocation: . e? ~_ ~ ~~
---u~ ~): .k,
200 amps or less 1~_"~5~4JO
201 amps to 400 amps ~-9.S~:~O
401 amps to' 600 amps $ laC. 00
601 amps to' 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
Items
.B.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
"
."'.n 6-()
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B"
D.
Branch Circuits
above
"
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting S 40.00
Limited Energy/Res .$ 20.00
Limited Energy/Comm S 36.00
5. SUBTOTAL OF ABOVE
5% Stat& Surcharge
3% Administrative Fee
TOTAL
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/60
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