HomeMy WebLinkAboutPermit Electrical 2001-6-14 (2)
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225 FIFTH STREET
The lOllow'og pro' SPRINGFIELD, OR 97477
zonmg end d ,eet as submift. (541) 726-3753
approvei oes nol require sp~ h,~s Ibe lOlloWing FAX (541) 726-3689
C"'C land
9 7 ZOning_ LD~ use ELECTRICAL PERMIT APPLICATION
~_ (, - "-( _ c) t .city Job Number DI-o 0 32 ?--O I
uthorjzed S' eJ<
Ignature _' )1
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
LOCATION fJf n;sTAL~. TION
crJ z:.. i:fLL/4/' l"l ,
LEGAL J).ESCRIPTION
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JOB DES.';RIPTION r (J It _
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
1.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical contractorC~ ~t1('..<jk.. Ek& Co
Address P () ~ f 421)/ (0
Ci tYCL<ffAu- OR. Phone -1(,1 t.SCio
Supervisor License Number ~~ S
Expiration Date~"
Constr Contr. Number 13'/<;/2,/
Expiration Date AfJ~/~()1
Signature of Supervising Electrician
~n.!- &!)/'.PfJtf0
Owners Name c-,){..v/leW LoL.~~
Address. 4 ( :3 ~ L i5:-d ~ tJ,'1
Phone ?-f 7 - 703 )
City
C (/1:::/\
vwn~ INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------------------- --------
DATE: c;:;G('-IO ( ,~1. ,\1
RECEIPT 11: ) v' 7
RECEIVED BY: ,...,~
FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Sum
Items Cost
1000 sq. ft. or less I
Each additional 500
sq. ft or portion
thereof /
Each Manuf'd Home or
Modular Dwelling
Servicejor 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
$ 85.00 <gS
$ 15.00 101l.
$ 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 liB" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.0iD
$ 40.0(ti -l
$ 20.06J:555
$ 36.0mCric,;
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