HomeMy WebLinkAboutPermit Electrical 2002-1-30
225 1'11' 1 ti STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELECTRlCAL PERMIT APPLICATION
CityJobNumber,b?'- OG/Q,7,-O/,'
3. COMPLETE FEE SCHEDULE BELOW
1, LOCATION OF INSTALLA);'ION
/95>'1 T d: ~.jJ~f-!,~eil A. New Rcsidcntial-Single or
Multi-Family pCI' dwelling unit.
LEGAL DESCRIPTION The follOWing project as sUbmit~tHflt#~WwJIbWtRg
/70 SZ 5 Lf '3 C):2:Q~Q~~ does nol require specific land use Items Cost Sm:n
D. Branch Circuits \f1~t.
New. tionorE~~~r
\~I1.(Q:. " '" 1jr\~u;t.. d'\~\S,iC
~tJne,Ci} . p \\J~
i\f~v,' '" 0 .' ',',. ~~ F-~~~
,.." ,M,1f\ ~;;)
E~'}(\ ,~~~JJ..\~with Service
or ~~~'Per~1\{I?\f;)4.~ $ 3.00
,"'; A"'!\ \)l
NY tU"
E. Miscell:irleo'us (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Zoning L 1>c12..
- :i1ee-sttfb.B+ 1"0<
Date l - ;io- Oh~'--fach-.illlditional 500
Authorized Signalur8<'{)hQ, ft or'portio;--'
Permits are non-transferable and expire thereor
if work is not started within 180 days Each ManuI'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
JOB DESCRIPTION
re. l'Cca-1e l1/Ie~
Expiration Date ;t;-l- 200'1
Constr Contr. Number' /t/S<t./ 3&
CitY6t14.'P","J> _ Phone 12CJ. -('l;;?itl
'-0
Supervisor License Number 'l~.o7 J'
Expiration Date /,0 - I - U (J L
Signature of Supervising Electrician
.~. ~/:/
Owners Name J::./24It /(;, / 'iJti,7eJ,)
i./
Address Ifsr J sf.
City ~J:t,.fJ Phone 5"7f" 507.J
OWNER INSTALLATION
The installation is being made on
property I o\vn which is not intended
for sale, lease or rent.
Owners Signature:
$106,00
$ 19,00
$ 50,00
I $ 63,00 (r; 3 ,.--
$ 75.00
$125,00
$163.00
$375,00
$ 50,00
$50,00
$69,00
$100,00
$50,00
$50,00
$25,00
$45,00
Minimum Electl'ic Permit Inspection Fee is S45.00 + Surcharges
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
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~ 5<11
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