HomeMy WebLinkAboutPermit Electrical 2001-10-24 (2)
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225 FIFTH STREET
SPRINGFIELD, OREGoflu1mlli1 SIgl1arute
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job NumbeOI-Q09'07-Q (
3. COMPLETE FEE SCHEDULE BELOY
LOCATION OF INSTALLATION
lID q S" 40 uklt'h
1.
New Residential-Single or
Multi-Family per dwelling
Service Included:
A.
'i
unit.
Cost Sum
$ 85.00
$ 15.00
.$ 40.00
LEGAL DESCRIPTION
l'?O-s3 !..ft(3
o <7/cr=
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
JOB DESCRIPTION ~
1-IMk fM? p~ to f)wn;~
.
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 Contractor IMdro ("jPs!t=>01
Address ?15.3 S. 5-+1-, :# 175"'
CitY~/'^"ir,& Phone 7'16-3512.-
Supervisor License Number 558 SI4'
Expiration Date /() - 1- 2~2-
Constr Contr. Number 12 'i? Sr; -'
Expiration Date 4- /5 - 2&0 /
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Services or Feeders
Installation, Alterations
or Relocation:
B.
i'
.I.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$40.00
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
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Si~~ectrician
Owners Name :~ ~.~_ kJ/Kl--~ 5?",~-!{D.
\?}vd
Branch Circuits
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New, Alteration or Extension Per Panel
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r- L
/..-rA-v.. r:-fr:.
Address t./O '7 '\
One Circui t .' $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit $ 2.00
f::1A.G-
r _X6'>7
Phone
City
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OVNER INSTALLATION
,E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.~GO
Sign/Outline Lighting $~0::'~G->
Limi ted Energy/Res S 20.jO'p::::?'
Limited Energy/Comm $ 36.~~
55 ~
5. JiU!lJOTAL OF ABOVE . ~. ~_ __ I
7~ State Surcharge S~~.
.g~Adminfstrative Fee .. z::3r..:lC1-.
TOTAL---'--~~ \
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------y;- --~----------------
DATE: I D r Q / c::> I . <' ,(--7
RECEIPT II: / f~ -/ ~ {
RECEIVED BY: ").12