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HomeMy WebLinkAboutPermit Electrical 2000-10-23 (2) e 0 oWIng proJee as su ml e as e 0 owmg loning. and does not require specific land use Ar-...~al ~-r\O_-r Zoning Dale 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 J.. ,..,(1..- 10 ~ ;;t'3-ot> <=K0 Authorized Signature 97477 726-3769 ELECTRICAL PERMIT APPLICATION City Job Number (")~:J- 0/ <:::;70 -Of 3 . COMPLETE FEE SCHEDULE BELOY 1'7 LOCATIO~ OF IN0ALLATIOth..JI nS,?,,() ojUVLP .(1 () W7 Kf.-X-. - I -r.n~l nuq~TPTION ~jr70.3,1'S'-{D 03/00 , JiB I DESCRIPTION / JJ4(1 / Permits are non-transferable and expire if vork is not started vi thin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY .B. Electrical contractoJP)F I f {TP (0 ),TVlC.. - ' I AddressUOloC:;/p). //~ #/X Ci ty (I j je.n e. Phone k'X"? -1::)11.0 Supervisor License Number c3F:J.:;) (~ Expiration Date i hlll/)I , I I . C. Constr Contr. Number ~+.S'87--c., Expiration Date_l()/~ /0' , f / uperv'sing Electrician - ~ Owners Name&Oo/.- A'fa };f1flr Address35~?;(')~,rn.f;/rt;, m .fl.i., ,/ Ci ty ~~P'hone fL/&-lrh/lf 0';lNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: --------------------------------------- DATE: Ii) RECEIPT #: RECEIVED BY: 2-'3 0= 35S"I i),r( A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Sum Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular Dwelling Service or Feeder Services or Feede~ 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 $ 15.00 ,$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 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 100u $ 40.00 $ 55.00 $ 80.00 volts see IIB11 above D. Branch Circuits " .-L New, Alteration or Extension Per Panel $ 35.00 ,:26.00 One Circuit Each Additional Circuit or with Servi~ or Feeder Permit r){ E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting----- Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 2.00 4[J1) not included) $ 40.Cf9 $ 40. ~c .:iL- $ 20.99=;~ $ 36. pgl':':l 'l' ~C') ~t:;l,go Q . Ut:J-l ~ I ~~g ....w- 0 /". .-""~ ,~~