HomeMy WebLinkAboutPermit Electrical 1999-12-29 (2)
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(\\":,~'2?5"FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
The, following projecf as submitted has the following
zonmg, and does not require specific land use
approval.
Zoning /... LA I
Date I.;;> ~':)<7 - cr q 'll.,ECTRICAL PERMIT APPLICATION
974AJthonzed Signature i\~ q <1' J!-, /1 ?
726-3769 ,,~ty Job Number II //d /tY
1.
LOCATION OF, INSTALLA!;2l'l/A .. I
b/ J 2 tf f1(trAN//N
I -
LEGAL DESCRIPTION
/1(J~ '!,4-4,/ /'JJ9@
JOB DESCRIPTION
fIU7f...K' r'l;2CI/I r
Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days. '
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor 4'1frI~ aJ ~rI/C
r .
City
RoY
IEI/6l.1.1t.-
23/51/
Address
Expiration Date
Phone 3'/'I-'I'l:Z-r'
~393- .s
/,1- / -uJ
~''f7
j'!1 t?f'- fJ I
Supervisor License Number
Constr Contr. Number
Expiration Date
Oyners Name
Address
City
Phone
7f7-g?Q
OVNER INSTALLATION
The installation is being made on
property I oY~ yhich is not intended
for sale, lease or rent.
Owners Signature:
------------------0- --~~-------------
DATE: /"2- 2-'Jr J!'i
RECEIPT II:' 17_1
RECEIVED BY: ~J~~r
3. COMPLETE FEE'SCHEDULE BELOY
A.
Ney Residential-Single or
Multi-Family per dyelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or ~ortion
thereof
Each Manuf'd Home, or
Modular 'Dyelling
Service or Feeder
B.
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
Items Cos t
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 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
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit I
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
36,0::>
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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TRANS#:01-0000121 '
DATE:DEC 29 1999
AMT RECD:2 $ 38.50
CHANGE:
CASHIER: 003
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