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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