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HomeMy WebLinkAboutPermit Electrical 2000-10-4 . ~:.'~' ':' . . . .' .. ..;:.... : ',<':':' . . '.' '. ..... .' 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 ELECIJUCAL PERMIT APPLICATION \,~(yJo.b NumberOCJ ~o/L(gb ~O ( rhe \5l\owing project as submitted h~.s the following. :~o'lIn9, and does not require specific land use approllal, ,re.-.. Zoning _ .t...D /0 - ;f~ (JIJ tvv--J ';"lir"lonzed Signature 3. COMPLETE FEE. SCHEDULE, BELOY 225 FIFTH STREET SPRINGFIELD., OREGON INSPECTION REQUEST: OFFICE: 726~3759 97477 , 726,...3'769 1. LOCATION OF INSTALLATION 'lIS' C., ;:;-r/Lc~'- ~G4L DESCRIPTION .(::::> 9-3.c:rc:> I' / 03 '3 ,C; I 3 Jt q O''-~~ JOB DESCRIPTION ttt:M.fL'1) 6. ( E y/ <I(~l ~n .41;; ;S-U'cn Permits are non~transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical J / Address Ci ty Supervisor License Expiration Date ConstrContr. \ J upervising Electrician ExpirationDa Signature of Owners Name ~j b R-U LJ . 7;J. Lt IL-rDJ ~f- " I r- c. City'Jt.''''71'',an Phone 'r ff-?, .....iG o INSTALLATION Address The installation is being made on property I own which is not intended for sale, lease or rent: " ~s signatnre/::::7 ~ . .A-f___U )lfdA~ i . v- --.~-----------~---------------------- DE" -looq"-oO ,IPT #: --:s:J 2.'2- . . EIVED BY: i:.:)f <: 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 Dwelling Service or Feeder 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 B. Services or Feeda~~ ~ Ins talla t ion , {iftera t ions or Relocation: 200 amps or less / $ 50.00 29 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation D. Branch Circuits New, Alteration or Extension Per Panel Items Cas t Sum $ 85.00 $ 15.00 $40.00 $ 40.00 $ 55.00 '$ 80.00 volts see '"B" above One Circuit $ 35.00 Each Additional Circuit or with Service or Feeder Permit . $ 2.00 Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL not included) $ 40.00.... $ 40. O~ t;"' ::;! $ 20.0~DD ---l ..,.. $ 36.0 ITI to ('"). ~ ('") t::l CJ .. ~,d;>"') .. ('") 0 ~ 'E:i:Y' r..,J ---l f-L :::E: I ?~I-l('")~oo . ":)0 ;0 :D U'1 .+:-. 8 I - - 4.:.b'" ..J GJ <('.,.". y:.u.-O GJ - .:;;t.!",'r f....., ~-.J f-L .. 00 I".J