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HomeMy WebLinkAboutPermit Electrical 2002-10-15 (2) ._09~~3/02 FRI 13:22 FAX 5417~4IIi89 CITY OF SPRINGFIELD . 1ai002 225 rll' In STREET SPRlNGFIELD, OREGON 97477 lNSPECTION REQUEST: 726-3769 OFFICE: 716-3759 ELECTRICAL PERMIT APPLTCA nON City Job NUmber I::le ZOOl..-OO 1/7 3. COMPLETE FEE SCHEDULE BELOW 1. LOCATlONOFlNSTALLATION . . 00Ii:Q (1arne 'to.\'"M I?d 5ori"Y1e)tiel(;\ C>>2(n~17 A. New ResidentiaI-SingIe or . - ' Multi-Family per dwelling unit. LEGAL DESCRIPT!~N _ " '.,. _ A '. d nas lno \S~2hocluded: C /70J"ZZtl Z>z:~ <liee' assubmll\.peeilie 'and use Items Cost . Sum - v "\1eto\\OW\~g~~es n~\-.eQU\fe 5 JOB D~CRIPTlON 19nin9. an (J)(I..- . or less $106.00 II\'&m-Ulttl\lYI flr- lV\tiIJ~v t '0 Ba .. 500 [)~s,q.~ Permits are n...._.....sfaablc 8l'4""";'" ~11__..~, " S 19.00 ifworlds not started within 1t'O~r.',zeo 519nalU,e Each Manuf'd Home or of issuancc or if worlt is IUSpcdl!mOr Modular Dwelling 180 days. Service orF~dt:r ~ 550.00 2. ,-v,uMCI'ORJNSTALLATIONONLY ,,~A B. Services or Feeders \ ~l Co()'\(l'l!J(\\Ce..tiOfl W""" Installation, Alterations or Electrical Contractor... c,{Wr, ~ ~sl(:ms. Relocation: Address IDID 1\1i(\1'\ Q- -If-U> 200 amps orless S 63.00 B\.X:lCl\le, D't. 201 amps to 400 amps 575.00 - CilV '\14bt_ Phone 9-1\- YtS- (Jbllt> 401 amps to 600 amps 'lO\)~ 5125.00_ '1/.r-=. 601 amps to 1000 amps ~\,eS \)'\\\\\~5163.00 Supervisor License Number .t-lt'VJJL..e , Over 1000 ampslv~e~,~o{\ ,,;::' \0 .$375.00 == l I fl~^~ ''0 oTI.'Ux. Reconneol~~ \'{\e e,e ,~~V~50.oo Expiration DatejQ 910L. t'-U\ lJ..W\ ~~"Q'l e~e~\l-~gJ \)\e'" - - . J . ~"'\ ~~<Si'F~ o{\0 Constr Com. NuInber (111 Lt l . ~€~%~ ~O~~~~~0-\\o{\ I I D4 \o\\O~",\\o{\ ~\JJ i\{\CO ~e..\~e ~o\~~ ExpirationDate 11 ~\o\\\"ooo~<1Md9\! ~.~o \)\~\~ '!J6.'1. S50.00_ I / \' ~~rt8~~,~~o{\ ~'l:?; 569.00 Signature of Supervising Electrician \{\ ~~erJ.ij\'fG~~_'O()~)-'3 = S100.oo = () ~608t~~W.\1000 volts see "~\.aS~ Ce~ fYI M"l> NOJ ~ ~ Chltctts. D. Branch Circuits OwncrsNamc ~II. Ctntt'd New Altcration or ExtcnsionPer Panel Address 1100 Nt> ~'fw<<;t OncCircuit 543.00 cl nil' -- Citv ~lOJ1tl t Ph~J~:.5P~g-~~~~rlditiOna1CircuitorwithService ~ ,\~~1; Permit $ 3,00 OWNER INSTALLATION \~~ \\ ~~ \ - - The installation is being made on ~\. ~i-'? ~S '?~~ ~~~sc~".n~ous (Service/feeder not Included) propertyIownwhidisnol~ed "o~~ ~'\~ ~\:)~ .Eachinstallation . fOT sale, lease or rent.",,~'\\"~~~~ \;)~\:)~ S ~'O~~ Pump or iIrigatian _ 5S0.00_ \' '(-.\"0 '? ~1.'t.<;) \:)~ ': ~ Sign/Outlinc I.ighling SSO.OO Owners Signature: '\ '!0'\'(-.\:)~ ~,,'t.<;) '?'t.~\\j . Limited l::nergy/Res _ 525.00 __ ~ ~~~ <;)~ Limited Enagy/Comm ---1...- 545.00 _ rl0 .9-1.) ~~'\ . Mioimum Electric Permit Inspection Fee is 545.00 + Surcharges ,- 4. SUBTOTAL OF ABOVE 7% Slate Surcharge /"~ _\ 8% Administrative Fee' 0 (. ~ TOTAL '$ Sf 7.~ LiS.CO - 3j? ' ;?..'t1S S1d:15