HomeMy WebLinkAboutPermit Electrical 1999-9-15
The, tollowing project as submitted has the following
lonmg. and does not require specific land use
225 FIFTH STREET approval ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zoning H- J:.
INSPECTION REQUEST: Utg-3769 Q __ \ c __ q q
OFFICE: 726-3759 lf~
Authorized Signature 3.
1. LOCATION OF ]NSTALLATIOlj . /
tj~2c( /,,(;f;<JJ'L/A! IlL.!;).' ,A.
,-
LEGAL DESCRIPTION )
-1!1~, (f}rrr
JOB DESCRIPTION
~HJI/J//a.1z'- ,.5P/liCe-. ~/M7Uc?~
Permits are non-transferable and expire
if I./ork is not started I./i thin 180 days
of issuance or if I./ork is suspended for
180 days. '
2. CONTRACTOR INSTALLATION ONLY
Electrical c~YE;_O.N. ELECT~I~: INC.
l".~:BOX 23,....
Address EUGENE, OR 97402
Ci ty Phone ?9!/- Y7'/f?
Supervisor License Number .;rj?~j?--5"
Expiration Date ///-/-$/
Constr Contr. Number ~~J?;7
Expiration Date m#f ~.~
Signature of superv~~ Electrician
'(:gr ~____
"'/# (4r= <;'l7fLBY
Ol./ners Name
Address F,Ox. Lfn,.6 '(;2-
Ci ty fl/f,tIJL 11l'~hone ,." l(j1.::3Jp5
OVNER INSTALLATION
The installation is being made on
property I Ol./p. I./hich is not intended
for sale, lease or rent.
Owners Signature:
~~~~;:-:~--~~.;~~~-~-~~~---------
RECEIVED BY: _~A
-q""'~ '/
l.ity Job Number
9i/2r;-,fr
COMPLETE FEE SCHEDULE BELOV
Nel./ Residential-Single or
Multi-Family per dl./elling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
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
uni t.
Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00 ,~tftl
S 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circuits
.'
Nel./, Alteration or Extension Per Panel
One Circui t S
Each Addi tional
Circuit or with Servicel
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
~jS State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00 /,l-tZl
not included)
s
S
$
$
JJ,(JO
~/, ~'I
Urn
?'l.2.6
40.00
40.00
20.00
36.00