HomeMy WebLinkAboutPermit Electrical 2001-2-9 (2)
The followmg project as submitted has the following
zoning, and does not require specific land use
approval
Zoning,
(l fl--.-
2,-"1-0)
225 FIFTH STREET Date --/ ,:.j
SPRINGFIELD, OREGO~"tRJ~U Signature U"\
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job Number 01- 001\3 -0 (
3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION
\OLlO b1o..:;te4 ~.
LEGAL DESCRIPTION
170 "3> 22 Z. D OZ3oQ
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
JOB DESCRIPTION
H re 4" Sec.uv:hr>o- SV\ &-tl(Y\
v ~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Items Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf',d Home. or
Modular Dwelling .
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
.' DB IT Ins talla t ion, Al tera t ions
Electrical Contractor Philios Electricl~{a~dor Relocation:
. €I ei/'>17f) '(,
Address , ?qR l'."I'],,,' n,-;v" ~SIvn$ 200 amps or less
201 amps to 400 amps
Ci ty Eul?ene Phone(S41) liRR-li171 401 amps to 600 amps
601 amps to' 1000 amps
Supervisor License Number ?7,q~ Over 1000 amps/volts
Reconnect Only
Expiration Date 10/01/01
$ 85.00
$ 15.00
.$ 40.00
$ 50. 00 .
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
26-34C
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
10-01-01
Signature of supervi~ ~~ician
./1
(;~J .
- athan pn111ps
Owners Na~e ~~
Address p, O. Box. ,I S''l '1
Phone -.:J:1/0 ~ Il./~ 3_
Ci ty ~A 1(1 ~ J/'J...
()
OYNER INSTALLATION
The installation is being made on
property I own which is not:intended
for sale, lease or rent.
owners Signature:
---------------------------------------
DATE:
RECEIPT tI:
RECEIVED BY:
OZC>9'Or
'-Nt:;,
.-,..,/3.
200 amps"oT 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 "B" above
"
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 Add i t i onal
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
oS 40.00
$ 20.0C?r, :--
$ 36. O~ ~~,OU
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