HomeMy WebLinkAboutPermit Electrical 2001-3-28 (2)
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
L~AT:r9~ OF INSTALJ..f>tION
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LEGAL DESCRIPTION
I ~O:2. At? 2-2-
.
JOB DESCRIPTION
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Permits are non_transfe=able anc expire
if work is not started vithin 180 days
of issuance or if work is suspended for
180 days.
2. COl'<'TRACTOR INSTALLATION ONLY
Electrical Contractor (:i,(2.JL.f1.t7J7lr(-c-
Address \If=rn f.::>-~O If9An LAI1.L,
Ci tY.$)kO Phone rQ(.:, ~ ~0() I
Supervisrlr License Number 3 </23 )"
Expiratior. Date / t/ / () I j' 0/ .
ConsU Contr. Nur.ober lj do-C;C;/7 (.
Expiration Date lO;!f);:(
.
Signature of supervising,Electrician
. J
// ...-----4' ~
Owners Name~;'(",^ ~<()'o\()_'\
Address ~oql /-ors\,t.h ~D..
I
Ci ty~I:::L 0 Phone
OVNER INSTALLATION
The installation is being made on
property I ovn which is not inteuded
for sale, lease or rent.
Ovners Signature:
---------------------------------------
DATE:
RECEIPT 11:
RECEIVED BY:
TRANS#:6l-0004785
DBTE:MAR 28 2001
AMT RECD:2 $ 40.70
ELECTRICAL PERMIT APPLICATION CHANGE:
. .: CASHIER: 003
City J~b Number 1?,/_~f}2-'7S--a;:..
COMPLETE FEE SCHEDULE BELOV
3.
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
Madular.'Dwelling'
Service or Feeder
Items
I
I
.B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 am?s to 1000 amps
Over 1000 amps/volts'
Reconnect Only
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocatiau
200 amps"or less
201 amps to 400 ampS
Over 401 to 600 amps
Over 600 amps or 1000 vo!ts
D.
Branch Circuits
Nev, Alteration or Extension Per ?anel
$ 35.00 :$../
One Ci rcui t \
Each Addi tional
Circuit or with Service
or Feeder Permit \
E.
Miscellaneous (Service/feeder
-Each installation '
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
7% State surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see \lBll abOVE
"
$ 2.00 d-
not indue
$ 40.00
$ 40.00
S 20.00
$.36.00
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