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HomeMy WebLinkAboutPermit Electrical 2002-3-21 225 FIFTII STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 . ELECTRlI. PElUvlIT APPLICATION City Job Number 0 Z - 00 111-0 I 3. COMPLETE FEE SCHEDULE BELOW 1. LOCATION OF INSTALLATION . .'btfl)q FdiC' QVI D (. Sp ri r\;{iCld A. New Residential-Single or . '. .' Multi-Family per dwelling unit LEGAL DESCRJPTION The '0I19'Y~ . , Service Included: '~ 170Z i94], ~onl~'{~W^'f!J>c'asSUbmllted '. . Items Cost Sum - -"'''''uvaJ ~ rsquire s ~~s the 101/0w' peclf,C la 109 I' /'i 00 JOB DESCRJPTION ZOning Co rZ. 11\'8o"~.ft. orless _ S106.00 /(/tP. wl1rrte.. !/louse D~i.dV1 =:::.;> _ Each additional 500 AU/Oaf/Zed" ',;},-O sq. nUl pOrtion 1/ 7/ 0 Pennitsarenon-transferableande~atur€ 2 S19.00 ~,O if work is not started within 180' days ch Manufd Home or of issuance or if work is suspended for Modular welling 180 days. Service or Feeder S 50.00 2. CONTRACTOR INSTALLATION ONLY B. ServicesorF~~~'t"" i?q~iresyouto r . f\T.lFNiWbl1G;;'~rtbit1fihtn6\lon Utility Electrical Contractor G 4 E 1= Ie (. 1"\" I c.. '1'ofto\7{rullSeldtill~d by rules are set forth P Q [().f~ Notiflcatloncenter.ThOse hOAR952-001- Address 0 UOX 0u'V inOAR9salOOh~1-Q~~g oftheru1es.ID'.-S63.00_ q r.i1.Q99'~O~3lJlfi\lllOII!b6IetelePhonll......- S 75.00_ CitLllJ bel ~1 V Phone 5L/r 07- if(tl6a1I'inlf~tft/'$6 n~~Notlllcat~ SI25.00_ J(}(J'()S numbe~~nt/lIjl~tVlfil6 .'2344). _SI63.00_ Supervisor License Number ,'X '1 rJ, ~uml6 ~ _ $375.00 _ 10/ I (2003 Reconnect Only $ 50.00 , ., Constr-Contr:.Nwnber J I.f '-I f?, R q 1/5 /2-003 Expiration pate C. Temporary Services or Feeders Installation, Alteration or Relocation ':1: Expiration Date 200 amps or less $50.00 NO~QM!nPS to 400 amps _ $69.00 _ Signature of Supervising Electrician bVtr'lfol ~~~dR~ IFTHEWOBKSIOO.OO _ ...[ -E? j(\ (\ n ~ -:=~~UNDERTHISP~A'WiITISNOT ^ s;;: c '~\ C r.nMMFNCEDOR IS ABANDONED FOR Ie" ') t 1...) -" ,L. D. Btlll\cliCiicu\!j OwnerrNaiile ....r) AN'N~~~la~~P2'hension Per Panel ~ vl:>fL .[ A-t.Ltry t::!.lciR. ~ Address P:J:'!. ~ ;.:' 3. '3 t't ,I One Circuit City~A-l~Phone 726 -0330 Each Additional Circuit or with Service OWNER INSTALLATION or Feeder Permit S43.00 S 3.00 Owners Signature: E. Miscellaneous (Service/feeder not included) . -Each installation Pump or irrigation Sign/Outline Lighting Limited EnergylRes Limited Energy/Comm S50.00 S50.00 S25.00 S45.00 The installation is being made on property I own which is not intended for sale, lease or rent. 190:~jlH::;\J~ : 39N\JH:J O~'60G $ G:Q:J3~ lW\J GOOG lZ ~\JW:31\JQ GL~8000-10:#SN\J~1 Minimum Elect..;c Permit Inspection Fec is $45.00 + Surcharges TOTAL I f)z,()() _'.:J,.7l.{. 1<./ ,5((' (J,oq, 30 5. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee