HomeMy WebLinkAboutPermit Electrical 1999-7-13 (4)
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225 FIFTH STREET lid Siflnature ' ffi
SPRINGFIELD. OREGON 97477 LJ
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INST~TION
/14 Ii Zl..L~ 5+. A.
LEGAL DESCRIPTION 17032. 7 () p /po ,,/0 7 '
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JOB DESCRIfTION . /d I
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SuperviS0r License Number
E"pirati:)n Date 10/1/01
Constr ()ntr, Number 104929
-
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number q<;r / z. / t{
3. COMPLETE FEE SCHEDULE BELOY
Ney Residential-Single or
Multi-Family per'dyelling unit.
Service Included:
Items Cos t
Su
1000 sq.ft. or less
Each additional 500
sq. ft or portion
Permits are non-transferable and expire thereof
if york is not started yithin 180 days Each Manuf'd Home, or
of issuance or if york is suspended for Modular'Dyelling
180 days. Service 9qLlifllll7ljl.no
ATfENTION:Oregon law r ~n Utility
2. CONBACTOR INSTALLATION ONLY f01l0WrLIl~ad6!}~le~l!'e~qr~=ffMh
'''lotifu;~tiOnCenflrrsnlp:J.%~~~~ eMions
Electric"l Contractor JB Electnc;:,c<'>IJ'Y 52-o01(()()~Y b
'" v' .. - 0; obtain copies 01 he rules Y
Address 4065 W. 11 th, 1118 0090: you maY~~rAl1lpta:0\fr81~!;,l!ho~e J{
"o,I",gthec l& wUtijay~fl~~w~n
Ci ty Euqene Phone 687_577@L1mber6~~~~ glt~WS3ll'&~' amps
u1 amps to 1000 amps
38728 Over 1000 amps/volts
Reconnect'Only
$ 85.00
$ 15.00
,$ 40.00
$ 50.00 2:fxl../
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expirati,)n Date 3/14/00
Si"''"1\m:'::: D
Oyners (ie-C....- 5 _(~rq G-b~ .
Address C _--: ):- 1'1lfu 0 tn..
Ci ty ~~ c..v PhoneSil..!;.. =? 13.. 't
OYNER INSTALLATION
The installation is being made on
property I oyn Yhich is not intended
for sale, lease or rent. '
Owners Signature:
DA~E~---------~~t-;rf"f----------------
RECEIPT II: /J (? Ii? n'1 t
RECEIVED BY: t:JI U..J
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
"
New! Alteration or Extension Per Panel
one~Circuit $ 35.00
Each Additional
Circuit or yith Service
or Feeder Permit ~ $ 2_00 ~
not include
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E_
5,
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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