HomeMy WebLinkAboutPermit Electrical 2001-2-2
The foltowin oject as submitted has the following
zoning, and does not require specific land use
225 FIFTH STREET approval.
SPRINGFIELD, OREGON 97477 Zoninr
. INSPECfION REQUEST: Z~~-3769
OFFICE: 726-3759
Authorized Signature
I..-D{L
1.'2..-~ ,
~
1. LOCATION OF INSTALLATION . I
?N () If Fa ( (I () VI - ~ f2-.Ci.tl8 {-'/alA
LEGAL DESCRIPTION
170z..191{~ 0 noo
JOB DESCRIPTION
11lVl()It' V/()iJ.$C iV)('iv11
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
'.
t;ity Job Number 6/-000 10 - 0 I
oJ.
w"rL.r:u~ FEE SCHEDULE BELOV
un it.
i
A.
New Residential-Single or
Hulti-Family per dwelling
Service Included:
Cos t Sum
'"
Items
1000 sq.ft. or less
Each additional 500
sq~ ft or portion
thereof
Each Hanuf'd Home or
Hodular Dwelling
Service or Feeder
I
'3
$ 85.00 8S,OeJ
~
$15.00 Y6.00
I
$ 40.00
2. CONTRACfOR INSTALLATION ONLY B. Services or Feeders
. __ Installation, Alterations or
Electrical Contractor tAE 6ffCf'tIC]I1LRelocation: .
Address PO SOX 1(P{}{P 200 amps I?r less
1/\ I h . .()(( CfTYZ I 201 amps to 400 amps
City_!--t I.JnJ~ Phone ,<,-(j(-Qf..7. rt;(PZ7 401 amps to 600 amps
/)q13 1 {' 601 amps to 1000 amps
Supervisor License Number ~ n~ Over 1000 amps/volts
{' 0 - J - 0 I Reconnec t Only
Expiration Date
Constr Contr. Number SLfLf fo91
q-Is -01
Expiration Date
Signature
X
of Supervising Electrician
,- c;.
G- U"G-
orr $;;;;
LlJP-'?-IN
Owners Name
Address :>0 {3.o;<" 70'1/ '1733'7
I JXI'
City ('=01'-1,''::, Phone 72b-O$>O
OVNER INSTALLATION
The 'instal1ation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: 0/2-'701
.'.r.,,"'.1rl tI: i-( :>btf
RECEIVED BY: 1>L
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
$ 40.00
$ 55.00
'$ 80.00
vol ts see. "8"
D.
Branch Circuits
above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5 .~UBTOTAL OF ABOVE
7'% State Surcharge ,
TOTAL 31;. q~ FN
7cJ1d
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00 :D
$ 20.00 =< :::-::f
$ 36.00 p1~'D
c-:lmCD
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Vji' " 1 fT1 0
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