HomeMy WebLinkAboutPermit Electrical 2000-4-5
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if) 6 r- 'S ~ %e following project es sub milled has the fallowing
zonmg, a_nd does not reqUIre specIfIc land use
approval .
Zoning Ll)fL-- ELECTRIcAL PERMIT APPLICATION
97477 1.1--'5 --O'1l , ' ,
726-39C!f ,\"~ C;T ';ob Number. /.70 _?>iP"? </tj , 0 I
Authorized Signature c::::r\,V-J
3. COHPLETE FE~ SCHEDULE BELOV
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
;< \?"'l'o 'i?"ko/}L (!.r:
45
00
AHT RECD:2 $ 49.50
CHANGE:
CASHIER :,004
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
j'}..L) ""?~ 3- '3<, d/ ~~
r
d JOB DESCRIPTION
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Permi ts are non-transferable and expire
if work is not started within 180 days
of issuance or if. work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor -j;lj()~u~ ett;e::r_
Address /r tP, A<9,t" a> 4 {,/
Ci ty f/Jt/ Phone 95'3-o0ri7
Supervi.sor License Number .~(!) J 7.S'
Expiration Date (0, j- OD
Constr Contr. Number //(0<.25'
Expiration Date /c9- /-00'
Signature of supervisi~E~cian
~/ ~N:X- )
.Owners Name_J;;-~ WL//A~-S
Address 2~b ~/Y~~ ~}'- r
City 1'~-.Z}#;? Phone 7f/"> ~~/
OVNER INSTALLATION
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home, or
Hodular'Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
It ems Cos t
Sum
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
C.
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 1000 volts
D.
8ranch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service~
or Feeder Permi t ~ $
5. SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
/
$ 35.00 3'5"'-
2.00
/0
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm S 36.00
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
---------------------------------------
DATE:
RECEIPT 11:
RECEIVED BY:
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