HomeMy WebLinkAboutPermit Electrical 2001-3-22
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DEVELOPMENT SER,{~5~.~fj'4J8 ~Tequire specific land use ,.
approval. It
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Date, "3""'" 'l- t--c;~ 7 \
L__ 225 FIFTH STREET .Authorized Signature, "cKW
SPRINGFIELD, OREGON 97477- .'
INSPECTION REQUEST:. .726.73.76.9__,,,., "....
OFFICE: 726-3759
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1. LOCATION OF INSTALLATION
745 C STREET
LEGAL DESCRIPTION
, 70 "3"3 s-, 3. II bO C
JOB DESCRIPTION
WIRE GAS FURNACE
Permits are non-transferable and expire
if. work is not started within 180 days
of issuance or if work is suspended for
180 days.
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
ELECTRICAL "PERMIT" APPLICATION
" .Ci ~'y. Job": N~ber O{- 00 I bO ~ 0 I
3. COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
s~. ft or ~ortiori
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
-~ Installation, Alterations
Electrical Contractor SCOFIELD ELECTRIC or Relocation:
Address PO BOX 2765
Ci ty EUGEN.E ~ OR 974Q2Phone 686-8n 1?
Supervisor License Number
3240S
Expiration Date 10-1-01
~ Constr Contr. Number 1R70?
Expiration Date 12/21/01
Signature of Supervising Electrician
7 ~)JI
Owners Name AMERIC~r:TON
Address
pn 'Qf)Y 1 j, <;;
Ci ty SPRINGFTEl.n
Phone 74n-17"?
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners., Signa ture:
DATE':
RECEIPT #:
RECEIVED BY:
0322-01
I.{ 7'111
-0(7
200 amps qr less
201 am~~ ~o 400 amps '
401 amps to 600 amps
601 ampi to 1000 a~ps'
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
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
ot:/
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Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit /
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
.7%, State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see "B" above
$ 2.00
,.--- "
no t included)
$ 40.00:I;>
$ 40. 00?:i =-:;t-
$ 20.00;;o~
$ 36.00~ au :t:t:
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This is your license.
If your license requires special provisions,
this section will be completed and should be
carried with your license.
:, .' .' '-STATE" OF OREGON . STATE OF OREGON '
ELECTRICAL SECTION
Lic./Reg, as: No,: 20 -1 C
ELECTRICAL CONTRACTOR
DBA
BUILDING CODES
SCOFIELD ELECTRIC
F'O BOX 2765
EUGENE OR 97402
ISSUED 08/28/00
Sign ~;J?;J
EXF'IRES 10/01/01