HomeMy WebLinkAboutPermit Electrical 8-12-30
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'. '''!'}ing project as. . L~ II; " "
., '" and does SUummed has the f..'L~
. c;:;roVal. . not requIre SP8cIftc Iend'~
225 FIFTH STllEET .'1 j). _ ~~CTRICAL PERMIT APPLICATION
SPRINGFIIU.IJ, OREGON 971..,., Zoning L lI'-V" /} / . ('J
INSPEC'l'ION.lmQ~~S'l': 126I?J%!J.I7-,/L,o/9i City Job Number VJ ;( 5-, ~
OFFICE: 726-3h9 Autho""'--' I ,
"'l:;IU SlQnature_ /') lb. COMPLETE FEE SCHEUULE DELOY
1. LOCATION OF INSTALLATION .
4- (Q~O ~ 1\ ()JI\"1 ~ A.
LEGAL UESCRIPTION
/ICJ~ ,):)-43> IJ%(ttrrD
ATT~f<!ih8~~~\1tl1J re~s Y?U t.~
.. 'I"s 3dQpten by the ~~o/e G
TOIIUVV '.... <J . Those rules are set WI [I
NQ!lfirriitlgn ~~~t~e61trMr6Utl't\ @Aflb !De2dlQ~ - e x p i re .
irn0IU3~R21'S' Ii :It ~~1Jp~i~ol'tH9ldu\eaOO days
009Cl.s'iQl!t~ ali.'No~gfi\1e:\el~pended for
186a\l109$oe center. ( Utility Notification
numberforthe Oregon 4)
2. cONmBhts!rmt1-ffi~*l2cl~,1(),N ONLY
Elec t d cal Call t rac tor#Q15r'. c:.o r-pora>>i CJ1\....
Mldress B9Q7Co J)~ La.n~
Ci tyE:uqeMe Phone ~-09()5
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SuperViSOl" License Number 15foB S'
Expi l'a t iOIl Ua te /0 I r I do
CUllstr COlltr. Number Bi.ft.J.3/
Expil"atioll Uate 9/3-0/00
...-....._.~-
New ResTCielldal-Single or
Multi-Family per dwelling unit.
Service Included:
Items
Cost
Sum
$ 85.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
tl\~l'+ttE: . $ 15.00
E~~~~~~~6~t~k ~IRE IF THE WORK
S~tJ:r~I~jWRdte0eln THIS PERMITslS4'l!Qilio
S (~n.MI\11FNr;F.,DFORdIS ABANDONED FOR
e~~s'~ ee ers
I n $,~'~rl iIt-a:J($ ~ rl1 P FA'-] f'fA- a t ion s
or Relocation:
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
~ew, Alteration or Extension Per Panel
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
~(j!!:!!- .
n.
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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signature of Supervising Electrician
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Owners Name ~ 0")"/'"-
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Address!jy (/J () (.1 rz~
Ci t~/JL~ Phone95g--"et)~f'
OYNEa INSTALLATION
The installation is being made on
property I OWII which is not intended
[or sale, lease or rent.
Owners Signature:
.">1~_
.,....
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DATE: /;).-J2n ) 1 ~ .
RECEIPT l:' ()3 'd-'-I.J- I
RECEIVED 13 Y : fl . /YYJ..J1.),..;.<4.d4{)
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permi t $. $ 2.00 /11 ~
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Camm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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