HomeMy WebLinkAboutPermit Electrical 2000-4-12
~ '.. bmitted has t\1E: TO ,..w,. ~....
The following project ~s :~Uire specific land use . ~f
. zoning, and does no r , ' TR~~S#: 01-0001215
~25 FIFTH STREET pprovaL 1:t)1fL. Eu;cTRICAL PERMIT APPLICA! ]~1fE : APR 12 2000
i.)PRINGFIELD, OREGON 9747' Zonin~' . ()O /\/lCIM1f/tJLTr.~ $ 1/,7 ~IO
INSPEClION REQUEST: 726-3769 If----\2----a:v \,;1ty Job Number -vvO\'U'~lmf~C[I$ '"to'~0
OFFICE: 726-3759 Date . ~. u C'. ~I. O' 59
Authorized Signature - 3. COMPLETE FEE SCHEDULE BELOV CAuHIEK. .
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION ~
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor J:j t ~ ti!.ecr~
Address <UJ() Box /lo9,h ~
City J}tbOcfL0f.-Phone SV/J?67-8feZ 7
Supervisor Licens~ Number ~ f.(2 ( 5'e
.. !v - l- 0 ()
Expiration Date
Constr Contr. Number :J Lf7 / S (l
Expiration Date
If).- /-()()
. . .
~\r:r~
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Owners Name ~r-~_ io..,...k..yy
Address PD l)1)^ J. ~CL-{ I
Ci ty()::/\~Jl::~ Phone -::J.;;)/:.,. ~~
OWER INSTALLATION
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
---------------------------------------
DATE:
RECEIPT #:
RECEIVED BY:
A. NewResidential-Sing~e or
Multi-Family per. dwelling unit.
Service Included:
Items
Cost
Sum
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or' Feeder.
I S 85.00 <85.0-0
3 $ 15.00 Lj5"rOO
$ 40.00
~
Services or Feeders
Installation, Alterations or
Relocation:
200 ampjV~T~~ $ 50.00
201 amPfH~p~QU.amps $ 60.00
401 amP1, I to '6t1&1/"kmtnALL F)(P/Rcl,lQ..o.. 00
601 am~ tfd~~ '-$'i3t1~~ORK
Over l~ttmJNt!e'tjbW/ ~ PS~06TQ9N(rr
Reconn,i\",y.Dn.lYA SI-\/jANDOOE!f.Pp8~
'~(JJj, Y PER/DO.
C. Temporary Services or Feeders
Installation, Alteration or Relocation
D. .
200 a~!TCil\ill~u/t;: $ 40.00
201 ~M?!~VttOJ/B9Qdl~~'.i'<-''' .,.,._S. 55.00
Over ~fiflC~bD~9n ~uYmeOr~dW.OO
ove6'oJi~~cqro . \llI:,'%'Iit;<s; ~e,:ili" above
O. You maYobt. rOugh 0A.f:.: '-II.:. ..'
caw am co i <:; 'k',.
Brancn 'UIDiclliatt~ntel (N P e", ot thb . utA<=: '",
numberforfhe Or~ ate:. ~he fe/Sprin!.:. .
New, Al tef'(!ltw>n,. QrR~RW~~~i~l)ti~~or;,. ~anel
, ... - . .
One Ci.rcui t
Each Additional
Circuit or with Service
or Feeder Permit'
$ 35.00
S 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting S 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. ~UBTOTAL OF ABOVE l30lr{)
7'%. S ta te Surcharge, 9" ("0
TOTAL 3fp C{~ Fl.-P 3,((0
. 7VTa)~~nt
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