HomeMy WebLinkAboutPermit Electrical 2002-7-31
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELEI..
~CAL PERMIT APPLICATION ~
, .
City Joh Number 02 -DOC:. S -3 ~ c (
3. CONWLETEFEESCHEDULEBELO\V
1. LOCATION OF Il'jSTALLATION
.3 3& L( (" I f::T"Tb!2...-I'J// 1~-fL).C:
LEGAL DESCRIPTION
I/OZ 193<-f
o()81JO
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost SU1)l
JOB DESCRIPTION . ~ M~Q~sq.ft. or less
5' E=.-cc\.. (2.. \. ,....". S. v~ 'e ~ . \ea \"\as \\"\e n~ additional 500
I / p(n\\ ',. cIa" .
. \ as sl.l. s?eC1 I sq, ft or portIOn
. . . (O\ec o.l.lI(e __
:ermlts .are non-transfe.rab1e\8I\19N~<p~6~S nO\ (e (l-- ___!l1eroof'-
If work IS not started wltlit~\~O:eTh~s (i2~c--'--- E(~C!l~ufd Home or
of issuance or if work is stJS'.Ji)re~,&ld for~ ~_.'-.~~)"" /Y' ~-tVfodular Dwelling
3......- Zon 4. I ~ , ~-- --- '
180 days. ;:::,-/'Ci~.--~~ce or Feeder
. Q: \e ~ ~,-,<>\,I,l(e .-_$
2. CONTRACTOR lNST ALtA TIg,J({ Gl9lL"Y B. Services or Feedcrs
p..1.l\IIOll Installation, Alterations or
Electrical' Contractor Relocation:
$106.00
$ 19.00
$ 50.00
City
Phone
200 amps or less
20] amps to 400 amps
40 I amps to 600 amps
60 I amps to 1000 amps
Over 1000 amps/voIts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Address
Expiration Date
Supervisor License Number /'" __
(
7'~
Constr Contr. Number
C. Temporary Ser'Vltes or Feeders
Installation, Alteration or Relocation
Signature of Supervising Electrician
200 amps or less
201 al-llps to 400 amps
'.. '- OVer 401 to 600 amps,
",:'; :eVe! 600 amps 000'00 volts sce
"B,lap9YC .,' <>
$5-0.00
$69.00
$100.00
. Expiration Date
Owners Name
IC!i~2... L fv1 ~LeUcrL..
S -72 !A. =\
Phone 706-- b 732-
D. Branch Circuits
New Alteration or Extension Per Panel
Address '2 S- 7
City StPPb
One Circuit
t!i) \1,'t
EacIh+'}9ditiona~ ~~~U~(~!~~rti~ . '~'. ,.,
'0'~:f~~de!,.R:~tiltLt;:;:i '~:;;,'~~) ~~~~""i)i~~:OO
~.;~:;~ i(~'ii;~i!\~"'i:;:)~;\rf;'\r~~~ ;~ ";~~~;~~.~.i '"'
E. MiseM~~'9~\fSt~g,r:vit~i'&Ust not included)
J:i:A?!~ci,\l~~~~P\i'~:\0,~~$J
F'HfI\B Q"lij:rr41dl~ v n
s~gwb~1li~e Lighting
Limited Energy/Res
Limited Energy/Comm
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
$50.00
$50.00
$25.00
$45,00
2~
~"/'
Minimum Electric Permit Inspection Fee is~ Surchargcs
, '. ~
4. SUBTOTALOFABOVE
7% State Surcharge
8% Administrative Fee
4~-
/
TOT AU
3,/ S--
;>60
(~