HomeMy WebLinkAboutPermit Electrical 2001-9-12
225 rlt'lH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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ELECTRl. ,UvlIT APPLICATION
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DpSCIWTION
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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.
City Job Number,Q (oTr~i~ ;i;,~/;;. 8Jmitted has the following
zoning, and does not require specific land use
3. COMPLETE FEE scIMffffl.et BELOW
Zoning
A. New Residential-Singmau~
Multi -Family A1dTiicfl.rISg~rlliPJr6
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
--. Installation, Alterations or
Electrical Contractor G4 t fIe c 1"f I'C ,J jI\ C, Relocation:
Address PO 1)0 X l Co 00 200 amps or less
201 amps to 400 anlps
City t~ \ bL;) v1 \( Phone 'o.'5L/ I ~ q h 7' 9fo2 7 401 amps to 600 amps
,,0 (J 601 amps to 1000 amps
Supervisor License Number 1')( ! d{) 5 Over 1000 amps/volts
Reconnect Only
Expiration Date
/0/ I (2003
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5L1Ljtp{i
qf/S/Z003
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ConstJ Contr. Number
Expiration Date
Signature of Supervising Electrician
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Owners Name {;.-fJ-.G7..
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Address ? 0 'JS cI --r Z (;) '-{ (
City lS:xz-,,1il1 r \ Phone 1?6 .o3J 0
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, leasf. or rent.
Ovmers Signature:
190: ;~3IHStlJ
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OO'itl $ G:a83~ lW~
100G 6G !:In\-;l: ::H tJO
v9S9000-10:#SNtJ~1
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Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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l~vBY 390
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C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
liB II above
D. Branch Circuits
New Alteration or Extension Per Pa.TJ.el
One Circuit
Each Additional Circuit or with Service
or Feeder Pennit
E. Miscellaneous (Service/feeder not included)
. -Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Cornm
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
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Cost Sum <3')
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3 $rO 57,00
1
:j
,1
$ 50.00
~
$ 63,00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
$50.00
$69.00
$100.00
$43.00
$ 3.00
$50.00
$50.00
$25.00
$45.00