HomeMy WebLinkAboutPermit Electrical 1999-9-3 (2)
ELECTRICAL PERKIT APPLICATION
City Job NUlIIber '1 '1/ l-/)"
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759 _ NOTIC~:
1. LOCATI~ _~~ INSTlU-LA.J'JON THISPERMlTgg~~xml\~~fi:'~~ BELOII
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LEGAL DESCRIPTIOV' Rny 'jJ, ,~rv~~~ Included: "
ANY1BODAYPERltiU. Items Cost
,
() _ ~OBJ DE.~CRIPTION L/
<::KY/'517HA..- !klhlrlS F~ 5tU/TU78S
; 0 ~ . sq, ft or portion
VI' Permi ts are non-transferable and expire thereof,
J.-. if work is not started wi thin 180,days)'\""~' Ea'ch"Ha'nu'fi'I1:'iiome, or
%,iJI of issuance or if work is SUSPi!~~ed~lfOrad(lP12IibHo'd~~~:(~~~l~r,p~'
~ 'f 180 days... NolifrcallOn Ge!"~r. 1 ncServl'ceror~Feeiler
, , in OAR 952-001-00'1 r t'1ro[l(1,'; ;~A:1 i:io<"\:lJ1-
2. CONTRACTOR INSTALLATION Olfu'!o, You mal' r.Bt~inSet\;i'ce's~roiU.'eEiders
L R' B bn~"iilCI"'<' c:o:nlcr, (Insta.:]!lift1'O'it1llfAl terations
, Electrical Contractor .. ra n'?~~';tT%tl1eOierOr IReloc'at'i'Ori~..m
Address 68 :West "Q" Street CPo"t','~ 1~i;o~3~~~;';~r less
. 201 amps to 400 amps
401 amps to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Springfield Phone 747-6638
Supervisor License Number 14735
City
Expiration Date 10/01/07
Constr Contr~ Number 08699
Expiration Date
12/l8/W,
Si~e of Supervising Electrician
r. _, -,: ~~ _
Owners N~~' r/J~?V, fA) ,r:p,
4 U
Address It} $k-tZt;~
Ci t~fMZ Q7tjotfPhone ~g,1/; 0(:,00
O~ INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovner~~~gnature:
",
". .
-----------~-t-7---------
DATE: 9./-l. 11
RECEIl'i' II: /I ' Y'J;J Ik., I
RECEIVED Br: ;?-/ VJI!MJ)/
1000 sq.ft. or less
Each additional 500
Sum
$ 85.00
$ 15.00
$ 40.00
/
$ 50.00 50. -
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders,
Installation, Alteration or Relocation
200 amps"oT less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 100ll volts see "B" above
D. Branch Circuits
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7,)t State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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