HomeMy WebLinkAboutPermit Electrical 2000-6-30
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225 FIFTH STREET 00 .yOR~ l" Sf.t
SPRINGFIELD, OREGON n.,4p'1f4fGN. C'D(.t~ ~{{G-t
INSPECfION REQUEST: 72f1-~7}9'C~D OJ'> 'D<fR l"J.,"P/R<f/~ Ci ty Job Number 00 - c:r-o-g73 -:- 0 I
OFFICE: 726-3759 1.),</ r 'T /s 'tis p. l"/i<f
PGR/OD -is-i4'DdlfR~-oH~~ FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION . ~<fD /S4'O
~ Ijl..{ I f () P NM ID~ i A. ~ R'lsidential-Single or
'"0 '>"'- Hulti-Family per dwelling uni t.
3Ob~oQo~h Service Included:
C::C::>b~l,>O':9b~ Items Cost
. 0"0 C?I.'
Oq. 9 BOt
'" <, '" '> "",,",n
JOB D];:SCRIPTION "ivI/) "-.. 0'>1;' O/~~ sq. ft. or less
LJ )~r..)/ p 1A6-<)~ 0 11~ M/U 0,"". "-....:9 . E~~""~di tional 500
. 'V~ .~t~!; portion I") 30 /.'::l.
Permits are non-transferable and expf~~ .rr"~",,, c;r... $ 15.00 .cru
if work is not started wi thin 180 days " ac "t"lo~me or
of issuance or if work is suspended for du Dwe!ifhg
180 days. Ser 'ce r Feeder
2. CONTRACfOR INSTALLATION ONLY
Electrical Contractor...d f E flp 12.-
Address fo 001\ I ro ~ (0
CityJdlbaJu f7~~~ne 8Cff-q(P7-~GZ 7
Supervisor License Number ;;<qx ,;( S
1('), I-Q ()
Constr Contr. Number ;;!U215(!
(Q-I-()()
LEGAL DESCRIPTION
;702 ']000
Expiration Date
Expiration Date
OWER INSTAl.LATION
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: _ _ c:c;.~9 c>_Q
Rr....".1rL II: ~3b'1
RECEIVED BY: . 'htY
B.
Feeders
Install ion, 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
;,;
'.
Sum
I
$ 85.00 85,{jf)
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
'$ 80.00
volts see "B" above
$ 35.00
$
2.00
Signature of Supervising Electrician
X~~~
o ) ( D. Branch Circui ts
'owners Nanie i\ (' 1/ f> ( t 0; { e (/
~ ~ (New, Alteration or Extension Per Panel
Address YO 1.) 0 X ZO '-{ (
( 0 One Circui t
City( ~vA-{ l <:. Phone 726 -Os:5 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 EnergyfComm
5. SUBTOTAL OF ABOVE
7\% State Surcharge ,
TOTAL 3~ Cl~ F/.P
'TU1a)
not included)
$ 40.00
$ 40.00 D
$ 20,00 =; -<
~
$ 36.00 ::U~$:
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