HomeMy WebLinkAboutPermit Electrical 2001-8-1 (2)
The.followln ro~' ~~ed asthefollowing
zonIng, an doe n r re ecific land use
approvel. II ,~
Zoning V,J... . ELECTRICAL PERMIT APPLICATION
9~~; ~/()I(.O f ~ity Job Number OI--CiQS""36~O/
Authorized'Signature _ 'hl; J' fll~r---
'~~)~ ~UM~~!E FEE SCHEDULE BELOV
1. LOC4rION OF INS!bLLATION~ #
17L( IDJ/HtZH./ ~fV f.-a. . A. Ne'" Residential-Single or
( Multi-Family per d",elling unit.
I LEGAL DE::jCRIPTION fl'or\.... Service Included:
7 03 14- 00 vv..L Items
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Sum
Cost
$ 85.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .D",elling
Service or Feeder
JOB DESc:t,~ION
'I2iW'-'R_ $e. , C;t.:r 8u'//r-4-"7
/
Permits are non-transferable and expire
if ",ork is not started ",ithin 180 days
of issuance or if ",ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
$ 15.00
$ 40.00
Services or Feede~
Installation, Alterations
or Relocation:
.B.
I CO. c:D
c- P---=-..,
$ 50.00 -=JC....< '-'--"
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
godr~,~
#(g'
Ci ty &~ Phone (pg'1-.)7"10
. Supervisor License Number ~ c:;{ 1- .:+p
Expiration Date lof, ( () I
. , .
Constr Contr. Number IO'-{91-C1
Expiration Date 3/ rw f 0 l/ '
. I / '
Si~~ian
Electrical Contractor~~
Address_ ~r w. 1('CfJ
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
Temporary Services or~Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circui ts
D.
"
O",ners Name 50'!-<;
Address tZ- '3 ~ ~A..-J..~ 1))",,(
Ci ty ':;;,/;CD Phone 9Yt" ~7fe..5"
Ne"" Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circui t or ",i th Service ~
or Feeder Permit ~ $ 2.00 ~U?'c()
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.Qa
Sign/Outline Lighting $ 40.00; -i
Limited Energy/Res $ 20.0.Q'DD
Limited Energy/Comm $ 36.<1Qimcn
5. SUBTOTAL OF ABOVE ~@, ~~3to, cJO
7% State Surcharge -(,.fiG' )~, 13 ~
3% Administrative Fee ~t:::;;~<- G, h
TOTAL n,." ~=",'"'''' Sf' q 10'--'
~'t"171 qt. -
. ......1.1.....1.-.J
. I---L-.Ot--.l.
OVNER INSTALLATION
The installation is being made on
property I o"'n ",hich is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: ,r>-;> -;> :5 c:::>=r
RECEIPT 11: /~77. r7
RECEIVED BY: -r-... /P - . c,
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