HomeMy WebLinkAboutPermit Electrical 2000-5-23
2
DATE:MAY 23 2000
AMT RECD:2 $ 22.00
CHANGE:
CASHIER: 059
u~CTRICAL PERMIT APPLICATION
City Job NumberO (J.. 00 a 0'1- O(
zoning, and does not require specific land use
approval.
Zoning Cf)r'L
5' - 2 "',- 0"Zl
M
Date
225 FIFTH STREET Au,"onzed Signature
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
3. COMPLETE FEE SCHEDULE BELOII
1.
LQCA]ION OF/JNSTALLATION
/;J.62. ~.!?Z H'DS~
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
JOB DESCRIPTION 1000 sq.ft. or less
5~/)'w.. S""sT~ Each additional 500
, ,,' sq. ft or portion
Permits are non-transferable and expire thereof
if vork is not started vi thin 180 days 'OOI&~ch Manuf'd Home or
of issuance Ot" if vork is susp\~d€QJ"'Ii3(jNIf8 'Hl'Id<YThli9i!lX/eping
180 days. lONSI11VVl:l3 IfSII:I(Sf1E:it~'lf~?vr 'Feeder
)j!:!nfl_~ d SIHll:l30Nn m 00
2. CONTRACTOR INSTAL~T ON ONL'<i1Hl::l13I:11dX-B.W ~erv!f~~HJ.fl'vFeeders
_ Cl :J I Iitls,ff1iI!i~tg,~t;l, Alterations
Electrical Contractor l'ZIJIooo'I .kChl'~ ~,S'. or ~~~I'tOi\j'n:
Address I?O. t!if'C ~/l3K~ 200 amps or less
~ 201 amps to 400 amps
Ci tyt:"~ ~ Phone 79.z~~~l& f" 401 amps to 600 amps
. 601 amps to 1000 amps
Supervi.sor License Number ~~G c,.- Over 1000 amps/volts
Reconnect Only
Expiration Date /t!)-/- .2....~,.z..,,~, '.
"~ ,_:_ ~, ',II/i'C.'10IT.e.'lP8F~JfY', Services or Feeders
Constr Contr. Number /t:) C,.t; /., .;: ~jO;\'\Installa'tilrIWnAlteration or Relocation
{. . " , ~,~(jr ,". :-~Uud :l/2 bU/lreo
:_ .':Of' '.. . u. !/el~'.r tP'/1 '''r_,'
Expiration Date. ~-7D - ~!'" - ..J"'1, '499,.ainI?t'~'nl!~2s
. " "0;;01, ')c. 201 ampsG,tolt400 amps
~ignat o~.su 'sing Electri'tiaJll8J09UJl.q";,JOlv)er"84.010/toJi,6f!,0 amps
'.~ '~r-O- ( nnP6'00 ., 1000
. .. , ,ye_~, - _' 11.;amp,~l,or vol ts
. .' .'-, '" '
l ~ ~ ~ D. Branch Circuits
~ners Name n/ P'~iVer De,""e/~C)
LEGAL DESCRIPTION
Items
Cost
Sum
$ 85.00
$ 15.00
. $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see liB"
aoove
"
Address
Nev, Alteration or Extension Per Panel
$ 35.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res ~ $ 20.00 p. (;1<#
Limited Energy/Comm $ 36.00
5. 170.06
SUBTOTAL OF ABOVE ~
7% State Surcharge
3% Admi.nistrative Fee
TOTAL ~ Gl. W
City Phone
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
OVNER INSTALLATION
The installation is being made on
~roperty I ovn which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT II: / ;;?L7 ..-J-.
RECEIVED BY: -
$ 2.00