HomeMy WebLinkAboutPermit Electrical 2000-2-9
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DATE:FEB 09 2000
AMT RECD:2 $ 73.16
CHANGE:
CASHIER: 059
ELECTRICAL, PERMIT APPLICATION
225 FlITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OE;;,INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION ./
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Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor13IfJNS El.fiCr((/c..
Address ;2../0 WALLIS ST1t. #(~
Ci ty Evto6v6 Phone G:. 37-/3(;2-
Supel'visor License Number ,3 04/-"';
1{)-I-1). 001
Constr Contr. Number 737bZ-
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Expiration Date
Expiration Date
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
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RECEIVED BY:'
City Job Nwnbera?-p~7-OI,
3. COMPLETE FEE SCHEDULE BELOII
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home. or
Modu1ar'Dvelling
Service or Feeder $ 40.00
,B.
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
C.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps Or 100v
E.
5.
SUBTOTAL OF ABOVE
~% State Surcharge
3% Administrative Fee
TOTAL
Signature of Supervising Electrician
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Ovners Name /~~4J -~-.:"'f"'-~Y""'
- /. . . - /' - . Nev, Al tera tion or Extension Per Panel
Address /"9~~ "?~A'/ A?vc--
. , ' / - . One Circui t
CitY_N~~C Phone L-,l~S/~')c:> Each Additional
--" - . Circuit or vith Service
01lNER INSTALLATION or Feeder Permit
VOlts
$ 40.00
$ 55.00
$ 80.00
see "B" above
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/
$ 35.00 "=?S.~
$
2.00
not included
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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Job: 00-00007-01
Address: 828 Royaldel Ln
Owner: Anslow & Degeneault Inc
FEE SUMMARY
Type
Building
Subtotal
Administrative Fee
Surcharge
Total
Electrical
Subtotal
Administrative Fee
Surcharge
Total
Permits w/o Srchg
Subtotal
Total
Plan Check
Subtotal
Total
System Developmen
Subtotal
Total
Grand Total
.
Received: 1/5/00
Unit: BLDG:
FLR:
Amount Due
J
Amount Paid
31.50 0.00
0,95 0.00
2.21 0,00
34.66 0.00
35,00 0.00
1,05 0,00
2.45 0,00
38.50 0.00
0,00 150.00
0.00 150.00
0,00 382.36
0.00 382.36
0.00 2,802,51
0,00 2,802.51
73.16 3,334.87
TRANS#:01-0000529
DATE:FEB 09 2000
AMT RECD:2 $ 73.16
CHANGE:
CASHIER: 059