HomeMy WebLinkAboutPermit Electrical 2001-3-6 (2)
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The following project as submitted has the fol oWing
zoning, and does not require ~pecific I~nd use
approval. ~
Zoning
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225 FIFTH STREET Date ~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON ~lIdiJed SignatuT.
INSPECTION REQUEST: 726-3769 City Job Number 0 1- fH) .;l 0 "'".:. 0 I
OFFICE: 726-3759
1.
LOCATION OF INSTALLATION
3/O,(Q I-"~ ~
LEGAL DESCRIFTION
l,D?, ,') U- -LJ;:).. n .~{/.,.tr7J
JOB DESCRIPTION _
Prl~ ~
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 ,B.
Electrical Contractor/.../aJi......... r-,'r<.~ ~~~
Address d-S II W. Sb-. ~~-
Ci ty ~Cl-4u.. Phone 4g,. S~ 0 S
Supervisor License Number l.l:L73" (( Er
Expiration Date J(} 1- loo?-.-
Constr Contr. Number
___ c.
7_ 0 . -=) 2. <) <'..U::
Expiration Date
. si~ure of Supervising Electrician
/11-. L---.. -
Wfe:: Name ~Qlt.J-L elCV1-<...-
Address 01'7 (, (:" nL.7L~ ~
Ci ty ft L~ Phone _2.!:U .:. L/ '4.1
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT I:
RECEIVED BY:
3. COMPLETE FEE SCHEDULE BELOII
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or port~on
thereof
Each Manuf'd Home. or
Modular'Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
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
It ems Cos t
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
$ 60,00
$100.00
$130.00
$300.00
$ 40.00
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
$ 40.00
$ 55.00
$ 80.00
see "B" above
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
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
$
$
$
$
41 3tr' -
ri. ~ J-
\ c'>~
(3,<1 . U. 0
40.00
40.00
20.00
36.00
3!L...--
~
-:.--- 1 '\0
225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769 Ci ty Job Number I:J I - n6l.oo~ I
OFFICE: 726-3759'
LEGAL DESCRIFTION
1"'10?J '04 LJ;).. Oi}..081:l
^ fL-!PB DESCRIPJ;ION . ,1c...<"jC,J::...""'" 1000 sq.ft. or less
v-nt;11.- OF- 1"'\f;SL.-v [.., v.... -:;> I c-r " Each addi tional 500
, /I ,S \.c..LLCsq. ft or port~on
Permits are non-transferable and expire thereof
if york is not started vi thin 180 days Each Manuf'd Home. or
of issuance or if york is suspended for Modular'Dvelling
180 days. Service or Feeder
1. LOCATION f!!}l~nAL.~TION fl ,In
2J9U' F- IL..-L..lnoLvv.. A.
2. CONTRACTOR INSTAL~~~~('AL. .B.
Electrical Contrac tor ~\ f2..E- '\- S&GuR.\T'i'
Address) c::,1 I W'=:J~ a.-uE-nuc-
Ci ty E:. UC:::rE:;- (\ &- Phone L\ 9:f.:J. ~9 09
Supervisor License Number
Expiration Date
Constr Contr. Number 1...-0 . ?'L~LE- C.
Expiration Date
, Signature of Supervising Electrician
Ovners Name 'lo~ fLO--G c-
Address~19LP FMI\'L....L!f) BL0p.
City f-UG-&(1~Phone/'-tI.l-f r~ {
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
GtO:~31>>S~le, lease or rent.
: 39Nl!H8
09' 6t QlI@~3!ligoo. ture:
1:00<: 90 ~l!W: 31l!O
61:9iJonn- TrI: !tC:~II-'\II.
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
3. COMPLETE FEE SCHEDULE BELOIl
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cos t
Sum
$ 85.00
$ 15.00
.$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
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
Temporary Services or Feeders
Installation, Alteration or Relocation
200 aoips' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D.
Branch Circuits
.'
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ ?O.OO
$ 36.00 .~
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