HomeMy WebLinkAboutPermit Electrical 1998-7-30 (2)
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225 FIFTH STREET Authorized Slgnature.01 /
SPRINGFIELD, OREGON 97477 "'i)'
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
. A. New Residential-Single or
I;' Ih' If, I: 10 Mul t i-Family per dwelling uni t.
,-v'Oo O~:"'~o ({/l9.\' ~()I: Service Included:
0, ^ r:90 'T 9,;_ '11 f'\ "'0'0 19o. Items Cos t
<, r; 'V "l\li; :01. oJ)
IJ. "'~. o({ '00 ~l9/, 19O' I,;>~
ffi'" DES(;!p:PJ1ilfi v""6'11.9t~""'?Y"00'06,J-t~ 0 sq.ft. or less 1.-/ $ 85.00 ~
.\\ 0 J:'}\n c \ \l~ 19/,,~ 19,,_ 06, '01lJ. 0.\'l9 e ~ddi tional 500
/ - (.l:l .t~l9-"tl91: 4/;,c "'0", /'v.~W.9Q~ll-98r portion
fer i s are non- transferable a7<cI- e~){Et-o O'cIQ '9~ 0 ~~;./o 2.. $ 15.00 ..1Q
if w rk is not ~tarted ,:,ithin l8~d.mJ) ~~'1.0S'0, ~~~'d H~me.or
of issuance or If work IS suspendedU~~~q,,~19t19 ~~ rr,.;,pwe111ng'
180 days. "'\{? :y~ V19LS.lf'lV,.l ~ or Feeder
'<?~o~.t'?OIJ. .....6,J-
.B~ ~~ces or Feeders
Installation, Alterations
or Relocation:
~Eg~
2. CONTRACTOR INSTALLATION ONLY
Electrical contracto--:B,/('S Z:/LJ.
Address "1 f 70
/I~
lAh.,T
City
Phone
9J?tJ 5
Expiration Date /0 ..:.. 9 c; -
Constr Contr. Number .;2. /1 S I
Expiration Date (j-;}- f ,... 99
Supervisor License Number
~r.F.r:TRTr A T PERHl:}1. APPLICATION
Ci ty Job Number l\ ~C'f'Af)
3. COMPLETE FEE SCHEDULE BELOV
Sum
$ 40.00
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
$ 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 $ 40.00
201 amps to 400 amps $ 55.00
s~ure of sup~rv"~' Electrician Over 401 to 600 amps $ 80.00
~ ~ ____ AI.Dver 600 amps or 1000 voJ.ts see "B" above
X-- '~U77c .
.~~. ~ U' DrHI!>pg,nS1 Circuits
~~~ ~ ~ -
I ~I(\ 'V C "'~~dl~,-~n or Extension Per Panel
Add~res~ I..I\A\ ' 4 C1f\.<::l AN~MM6iY"Er1~1&ft?.,.:::Rf/F"'H~ $ 35.00
Ci ty '\\1 ~ Phone 1 1'1ll!..L( 18~~ .oK<RI%.J1.'I.:.:fRMI1' ~
Clrco!?k1Rr .~\I.$erV~a'tO.,.
IN LATION or Fee&:'er Permi 1."'0 FO.o $ 2.00
The installation is being made on
property I ovn vhich is not intended
for sale. lease or rent.
Ovner~~ignature:
-,
DAT~~~--- I) -~'I() q ')( -^~.,u
,RECEIPT 11: 'v-1 ~1c.:1...L
RECEIVED BY: ':J\ V;J)._l
,"
E. Miscellaneous (Serviceifeeder not included)
-Each installation '
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ~/\~~
5% State Surcharge ~.~JI
3% Administrative Fee '?.oj.r
TOTAL /!i.-{2.0