HomeMy WebLinkAboutPermit Electrical 1999-11-10 (3)
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The tollowing project as submitted has the toll owing
zoning, and does not require specific land use
approval. J
Zoning r-U I ELECTRICAL PERMIT APPLICATION
/1- I c:> - '1 7
Autnorizea Signature N
J. COMPLETE r~~ SCHEDULE BELOV
,
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3~
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
/96"/ p~# -"5Y '
LEGAL DESCRIPTION
1?,.t>~.;r/.'2U_ ~/~~
. ,
'::'~ ~:. Job Number q.qJ'a //
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
JOB DESCRIPTION ~
W'~(~~:R 6l~AYc'.r _ ~C
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 Contractorl'7lS &ctv IG,\nG
Address Do ~y 1407..-
Ci ty t7(.lhJ Phone f-f1-~2hro
IIfMIS
Expiration Date 10-01-0 \
Constr Contr. Number '2))ILtCj
ID-D I-CfCJ
Supervisor License Number
Expiration Date
Si~of~lectrician
ct..ers Name;r~~p~_~~~~n-
Address /~-'!i'/ AAt' Gr.
City 4"P~_ ~.Phone -?2~~
".. . / .
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT If:
RECEIVED BY:
J/-.(}-"11
I
0<. t,L/
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular, Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
It ems Cos t
Sum
$ 85.00
$ 15,00
. $ 40.00
$ 50.00
$ 60.00
SlOO.OO
$130.00
$300.00
$ 40.00
c.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT 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
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit ,
Each Additional
Circuit or with Service
or Feeder Permit ~
E.
5.
SUBTOTAL OF ABOVE
1% State Surcharge
~% Administrative Fee
TOTAL
$ 35.00 ~~,~
$ 2.00 /,$. t!:>if"
not included)
$ 40.00
$ 40.00
$ 20.00
'''$ 36,00
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