HomeMy WebLinkAboutPermit Electrical 2001-2-9
The following proJect as submitted has the tollowing
zoning, and does not require specific land use
approval. ........ r'Z-
Zoning L.:u I1LE'';TIUCAL PERMIT APPLICATION
97477 '2-'1 -0 ( \
726Qg'F6; of(u.J City Job Number6/_ OO/l'-l-O(
. Authorized Signature _ .
3. COMPLETE FEE SCHEDULE BELOW
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTAL~ION
3:So, 2 Fa. Ie ~V"\ LJ r ,
LEGAL DESCRIPTION
170L )94~
C> 8'.30-0
JOB DESCRIPTION ~
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Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
"
Phone
Supervisor
Expiration Date
Constr Contr. Number
Expiration Date /\
Signature of SUP~Sing Electrician
The installation is being made on
property I ovo which is not intended
for sale, lease or rent,
,.--
~
-----{---;------~----------------------
DATE: '-../ 020'70 ('
RECEIPT l!: '-N/V'
RECEIVED BY: "\--... R
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dvelling
Service or Feeder
,B. 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
Items Cost
Sum
$ 85,00
$ 15.00
,$ 40,00
$ 50,00
$ 60, 00
$100,00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
L I, D Branch Circui ts
Owners Name 6' re...q O\,V" ~ \ ~ .
'" ~ New, Alteration or Extension Per Panel
Address V.D .13(\" 204 I
!') A' One Circuit '
Ci t:k.~21 t'vOI.l \ ~<:; U/Phone-5<t I ~'Z4..Q..:.43' 7 bEach Addi tional
, Circuit or with Service
OWNER INSTALLATION or'Feeder Permit
(
'-10
$ 40.00
$ 55.00
$ 80.00
volts see IIB11 above
.'
$ 35.00
$
2.00
not included)
$ 40.00
$ 40.0Q,
$ 20.00'i....,,::;:j
$ 36.09:,~~
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