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HomeMy WebLinkAboutPermit Electrical 2002-7-22 '-: :"",-,,00-' %"':.',' "; :j?'.;:'::, ' ELEC ~ :,...1':AL PERMIT APPLlCATION '~r:f~~~::~t!Jt3~:gflTfi; '5 ,'; ;i<:;~" ':225 rJYIH STREET " . " ~S'piuNGFIELD, OREGON 9717:,/ ~ljI~SPECI;tON;RE.Q ~ "'72\?~2 , OFFICE 726 37-9 0\<~ ti.'" ,..,:;,- ,), "<~ ':~",'><"'::"'):k\< ::~: ~;\l#P ,}#'v' 'j 1. LOCATION OF'iNSTALD~l'ION 90 b ",,'.'~ ziT:' M't A' /) oi:b .:s' spro OA- 91'(77 LEGAL DESCRIPTION /7rtJ,~ 2~ 4f? J:L9~tD ~ . - "\\0; ~.;.J;i-,,;' -,.'.' ~ ,:~ '-'- ^ 3. COMIJLETE F "-',',YJ;: .'~,/ h' ~'CitvJob ,'- "~4 }W~,:',: ;"':";'$ i%:iq~ , ~":v '" /\', , ,,< ,::^J ('::Jt;-~,,"" " '--,..'--.' A. New RcsidentiaFSingie,,:t;>o Multi-Family per dwelling unit. Service Included: >;~~V:~~,'r>::,";; -\. Items Cost SUl:rr JpOB DESCRIPTlqN Ethe ollowtn.~ pr~ct as submitted has thkqgRo~c;Ut" .or les~ Il..<.. - eN I"\..<. .se.( '" , a"'flfuefs<i1'iM\require specific l~b~CfttlOna1 )00 !, app oval. sq, ft or portion Permits are rion-transferable and e~Mlg _I DIL thereof if work is no, t.,."started WithiB., A\.~,O d.ay. s . -7, -. '2 "'2'-0 J-:?- Each Manufd Home or of issuance <:ir, if work is suspended fo~ 'Co' ,. or< Mod~lar Dwelling 180 days, ", A 1-0",,, ,vlld;U vlgnalul6 0,:,;; ~.:,~ ':'f' Feeder v $106.00 $ 19.00 $ 50.00 2, CONTRACTOR INSTALLATION ONLY ;>, ~ :.~~'~~:>,~ /\ B. Services or Feeders,., ., Installation, Altcrl!,tiori~()r:. Relocation: Electrical' Cbritracto $63.00 $75.00 $125.00 $163.00 $375,00 ,$ 50.00 $50.00 $69,00 " .EXP'R~]$tfttlIMNOR~ "~;'~~boAtn O,.~fflH!S. PERI\jnTf~R NOT . M\\IlE\\!CtElO O~ IS .' . ..' , D. Branch C ~laOraA" ~g,R~O~;'"J NewA teration or'Extension Per Panel' [00 ; 33IH8i1cl3 . iOjHLn lr't l: ':1">-' I\!.\ff''h:; '> 9L . -m$l:G33H IHl;;I '"1U~r' -t'. "7-'1-'1'\. "1' j..;!rt 6 L.lf:L wt, ..J/$.. ~ .J' vt{ > '- ! nO(17' ;'f) T~' . ~F"}.!Lj\j 1 6V' \J 1"Uv""'U"!",<~!ft\J':;'l.J:: ,n'~ " "<~~-tj~{2~~':;~ ,:::}L, . . OWNER INSTf\.LLA N, ,~.>: 'The installation is, being ;nade on' " . property I o\vn which is not'int€nded ,forsale)'lease oi:renf~i. ,; 'v E. ",d% ,., Ol};"l:::?I!'P G-G€€-f)o~~rs!"~~01 E'~C~;'~'j "Ban ~if~~~QtB~~~~bl~~~~u~~~u or~eed '~rn\1ralniQ,se!dOO u~~f\o.\'Q€OO ~n:i.J5no..lut 0 li'lOmOO-2:S6 ~~o U! .:t\feU~.' r not l'ilcru.lle, "'1"\ U^P'eOI'.I'ON In..! eSOlU..Ie ViI,.j, '"'A, $.~ , 9tH I\q paldop~~ff'8a MOllo~ .1 Mel uoue.lO'I'$~~~~I:iU\l $25,00 $45,00 ' ;..: {",- , J .~: -.-'- :~>"">' ' Minimum~lecti'icRermit-~~sJlcction Fee is 545.00 + Surcharges . ,;.. ",;", 4. SUBTOTALDFABOVE 7% State Su,d:harge '. 8% AdministrativcFcc. TOTAL ''''I 225 FIFTH STREET SPRlNGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 ELEL.e,.JCAL PERMIT APPLICATION City Job Number ()7.....6C)$2.{-Q I 3. COMPLETE FEE SCHEDULE BELOW 1. LOCATION OF INSTALLATION t/j ~ ~ :;1111 h-+ l~ iN '1 LEGAL DESCRIPTION 170'5Z~SCI3 A. New Residential-Single or Multi-Family per dwelling unit. Service Included: /zc;oo Items Cost Sm:n JOB DESCRIPTION ( 1000 sq.ft. or less ~cl ill ~;b-.:-n-'1 ~ V'fhP.fM(ff,.,~ ' Each additional 500 . ." fJ'VJt:ct as s b ' zoning, and does not U ,mltted haJF,t~<1eIAAfMQn a require sp iiir. Y Permits are non-transferable arrElIt!'.<{J'!flIe eC'fItt:~tM1 use if work is not started within 180 days Zoning __ L.-b (l- Each MamIfd Home or of issuance or if work is suspenElw for -2.-;;; l., ._ O~1\J10cl~l&f.J"hVe1ling 180 days, A' -.. '.. , -'Ice or Feeder uthonzed Signature ~ ~ - 2, CONTRACTOR INSTALLATION ONLY B. Services-()iO~Os f l r i r Installation, Alterations or Electrical' Contractor r i~ ,oh~ ~ ~\ ])1 c,.. Relocation: , ) - '7 t~ $106.00 $ ]9,00 $ 50.00 Address j it t '" City f/,^-{,;/ll'~_ .. iJ w ~;' ,,<.: Phone ~ l;, _0' ~IJ. ~.' 200 amps or less 20] amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 63.00 $ 75,00 $125.00 $163.00 $375,00 $ 50,00 Supervisor License Number Constr Contr. Numberl "2-111 :s. {-, C. Temporary Servkes or Fce<<eI~:);:~ . Installation, Alterati9n'(;f~f.\lfiehfion-{;" i<.~::I'::',: :"",\;;" >j'~;};: it>" j 2oQampiiffr1e~is':i7:1 ~\,::" '. $50.00 ; . "'2,o},{1ntPS:f.p: ;400: ~pSt~"~o... ':';1;$6 9 . 00 . '. \\t~~ SV:~r 4111to'6,f)U]P1p.$]\:", ,t '; ,;;:r~:>;~" $100,00 '\;} ," "tiXrer,t;lli},; anm..l;: J6r'l o O,QVo, I. tl', "ee".. : ",,\\,} I"O'~ ' """'~ '1,.. ....~...",. ,.t~\"" 'J,o""JPb ',/'\. " ./." "-\." \':\.;<\T..... A)j'{,,:,:~~ '\}V ~'\\';~P'.~,.P~""1 ,~\~F!)\" 1:_ (~\~'j~,(");~.~,'~;J~ ...\~p' ~'~';'" ~j"r;. .~\.\~~\'l.. :,~;)~P' ~ t~;;i'\~' ~ t:; '.~..f~t~\~'>:"f~(~t'1<"~,)' D. n;Hih~\€'i4'9-ti1~.\~l", "";'~u' -.:: .<4 ';' ' "('\ -:".' fJt;\:X\A'fterat:i6n:or Extension Per Panel ",'." Expiration Date E . , D j i &'),14"01 xpuatIOn ate~; , l 'VI l&. Signature of Supervising Electrician /) /"\" ~ " (j' .1'. " I'?rlZ.~r f{Aj tt{)~ ~ ('J i t\""'O..V' .--~~' , J L..- I v <"'''1? '7:>) Owners Name j;;;i1tf2-y J5L7 &-' 7 - I' ft-. c +- b :::-> Address ZZz. One Circuit $43,00 City SP;:-'7:::> Phone t;tf7 - Z '{ If 7 Each Additional Circuit or with or Feeder Permit ",,(:'7. ,1"( \::$~, .00 OWNER INSTALLATION . ,t;~;,;,'c? ....\;\',~)",,,:i\ "?_~,,:; " '~~'\/ ~ ~'tl ..,~ '}/'~;;\\ The installation is being made on E. Miscellaneo,us (ser~:~}~~~e~~~~-Qtl~~~'j property I own which is not intended -~~Ch~#JlstaF~tipit~nJ';:~:('''':,:3'.'f},,,, ~~ for sale, lease or rent. <Rhhi.p:ot:.iM~atiQ.\t;;~" ';-'\0' $50.00 '0~(&StO:Ui~e;~~~~&i1~,~)~\~tJo $50,00 Owners Signature: L~i.1~(l\'E~~;gy~ElS\r"'i"" $25,00 Lif;~~4'~:&!';'lw,€c;mm $45,00 \,; , ,,\' ,\v \"~' ,'t. :Minimum Elci:fric Permit Inspection Fee is 545.00 + Surcharges " . .1'-' ._" ..,r, 4. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee (If J/r :J tv TOTAL ,11 '( ~ 'f'S,1 -