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HomeMy WebLinkAboutPermit Electrical 2002-8-19 . 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 . ~ ELEaAL PERMIT APPLICATION City Job Number 0 Z -0 09 '7 '7-0 I < 3. COMPLETE FEE SCHEDULE BELOW 1. LOC~ nON OF INST ALLA nON 1\ .Ie J hS 7 Dl::--z:.,e.ost: I'l vc: A. New Residential-Single or Multi~tll&ily per dwelling unit. A. S IlleWl~ncJuded: ,-,0 I Z. 3. n""I\Oo \'I0\IC \0,,0 s\)V neC' eC\ as \.\\(0 51' . o?'O\ l,eCl \l0"\"~ oeS ,,0 Vb: 10 . Sb/hl'\:~~!~if( 0'2: ach . 0~a1500 .(0 c.((2.~ ~0","9, \ ~ . fl or po Permi are non-transferable and expire if work is not started within 180 da)'S Ie l\l,e of issuance or if work is suspended 'ftj} (l~eO 519,,0 180 days. 1'\1,,'0 LEGAl- DE~CRIPTlON nUS 2Lf3>4 .( Items Cost Sum $106.00 $ 19.00 Each Manufd 1I0me or Modular Dwelling Service or Feeder $ 50.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders (l ~ (' - T': Installation, Alterations or Electrical Conlractor~,-"') ElfdJiC)--\...rc. Relocation: Address ~O. ~K \L\-~]... ciSorirdklol Phon;lY \ f~2-30 { j Supervisor License Number 4gV)L(.S IDldm 200 amps or less 20 I amps to 400 amps 40 I amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only -.L $ 63.00 b 3, $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Expiration Date Conslr Contr. Number ~ C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date q j II 02.. 200 amps or less 20 I amps to 400 amps Over 40 I to 600 amps Over 600 amps or 1000 volts see liB" above $50.00 $69.00 $100.00 Signature of Supervising Electrician ~ ~QF .JlOQ.. Owners Name 1'\ -Alii '" j OJc=A-LL D: Branch Circuits New, Alteration or Extension Per Panel Address I b <:;7 I:x:-- f r <0 S ~ AI t' City. sf' fi\ Phone - OWNER INSTALLATION One Circuit $43.00 Each Additional Circuit or with Service 3 0 or Feeder Permit -1!2... $ 3.00 _ The installation is being made on property I own which is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lightinl! Limited Energy/Res Limited Energy/Comm TOTAL $50.00 $50.00 $25.00 $45.00 crs b'S( 74'1' (06 'IS- Owners Signature: mO:(j3IHS~8 : 39N~HJ g6'901 $ G:083(j lW~ GOOG 61 9n~:31~O G~~0100-10:#SN~(jl 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee . . . , ..... ~~ ~ :D 3: ...... ...... 0:::<:1 ;0 :D :D I'll ......:z: C"J rr1 CQ o.~ =** n ..::r>-. D I".JCQ OJ m......,. :c ... I .-.C"J )--LO rn:c~....oo ;::ODe ~ .. Zcr-.NO OQ. OLoJ o rn....o o.p.. L~J..(J1t...Jt'\J