HomeMy WebLinkAboutPermit Electrical 1999-9-16
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An E!\iTION.0tegof, ;aw requires y( I RTHIS PERMIT IS NOT
fO~I?W ~ules adopted by the Oregon Uti!' l - 0
The fOIlO~~Aa~fO/&rlf'8!;)sUb.mitt~,c! 1'1~~d~ltf9!1,9&l:Pgre " COOMMENCED OR IS ABAN~ONED F R
~Onl;og~a~cm rabe~rtos:r~g~r,e.eBE11!!i81~tr8giJrfOAR 9~~:~~Y 180 DAY PERIOD,
pp ~~?o:}~u.1;.r!i~in copies Of trEJ.~~~yAL PERMIT APPLfCATION
97477 ~.!r.~ .. '" ~~H"':'" t~\fP{f.:" me telephone. ' 7" , '
DlG6 37~9\mberfnd'r;lc>,~l#."3:;,',,." ,,' G4t;v:.Job Number aO r-II
, '-"",:-:""Y"'''Y '''ju.."C~tICil, / ;;) J ,
Authorized SignaturQ~"?:f'" iS~~3.?~:::344)' .
j. CUl1l'u.TE FEE SCHEDULE BELOY
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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-iJJOB DESCRIPTION ^ '
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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.
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Ser~ice or Feeder'
Items Cost
SUIll
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
/l Installation, Alterations
Electrical Contractor Ud'it//R/J!//J !l4{c-r~or Relocation:
Address t:tJ. /~/r/C ' tV/J('P'A/'100 amps or les~ '
/J . 201 amps to 400 amps
City ~A~('w~ t:-L Phone Q cr~2 ~5"~ 401 amps to 600 amps
601 amps'to 1000 amps
Supervisor License Number Over 1000 ampsivolts
Reconnect Only
Expiration Date
Constr Contr. Number Or; ~C(?rl) .
Expiration Date_ 4" ~2c1-d1
Sign~, tur Supervising Electrician
Jtq (7 f?l.t?.#~
~ ( - - "-
Owners Name~ ~~711
Address_Z'3G. j!~, ST ' ,
City~~ Phone c3~~-S~
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
q-/(P-,q _,,'_~~.,
RECEIPT #: .. ()~~ .,) ~ ()~
RECEIVED BY: c:::xi0, i
DATE:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less $ 40.00
201 amps to 400 amps $ 55.ob
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circui ts '
,.
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
Each Additional
Circuit or with Service
or Feeder Permit
E.
5. SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$
$
;/'$
- $
40.00
40.00
20.00
36.00
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