HomeMy WebLinkAboutPermit Electrical 2000-1-7
~
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
,9...?,y, t200tJ~ er
9 f~r-,
7'l!&<>rJt.!ill9>ignature
/ ~}~1I~ ~200
JOB DESCRIPTION
('., - 12verJA-CI,._ 11..., . I .J, -I-
Permits 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$c, 0 2(7'72., <..
Addr~ss p. 0 -Go.,.: ~ 'i ~ 1-
. .eCi ty ~ ~ _ Phone (",.r' b -Io;)- '3 c:..
~ Supervisor License Number 3'(1") "
Expiration Date //J-! _ n I
Constr Contr. Number ? O~~"1
Expiration Date /2-- '), D - t') 0
Signature of Supervising Electrician
+-- '-'-~
Owners Name nn <.J t.- '- { (~
Address .J-'\ '-/) (200......~ iT
City~!e'JLC~ Phone 'll.{f;"'J{}01.(
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
Ie .
D~TE~-------{-1-~1~~------:--------
RECEIPT #: 'J" ,'-6ftt
RECEIVED BY: y-. 1v L.vI /'-.-'
4
DATE:JAN 07 2000
AMT RECD:2 $ 59.40
CHANGE:
CASHIER: 042
ELECTRICAL PERMIT APPLICATION
I;i ty Job Number rm .- 0001 ()
07)
CJ'0.)
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Singl~ or
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq. ft. or less S 85,00
Each additional 500
sq. ft or portion
thereof S 15.00
Each Manuf'd Home. or
Modular, Dwelling
Service or Feeder S 40.00
B.
Services 9~rfeeders
Installat;o~~~ilerations
or Reloca ~,8: 0;;:
40.,." ~-9~
'200 amiVbip~,;,,,r7"8~..q ,. S 50.00 5nDO
201 a!l\!lS Vl1~k,Qff.''laaJls '-l. [::,,~ S 60.00
401 amil~ 1'JIJ. '~/)~~S>~~~SOO. 00
601 amps ~\)OWO'()~ 'Ift!.<:.-,:> ' 00
Over 1000 amps~;s'1~ ~~$R: .~~
Reconnect Only U~ 'UO~~ ~~ ~
D"<:-Q 0.,.
Temporary Servi ces or Feeders If:1
Installation, Alteration or Relocation
C.
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
The following project as submit!er1 I'1PO: thp fnU"wi'lO
zoning and dOG5 no; reQI..urt- ::';..rec.:llll- 1&110 U~€ ~
approval. "t"\ \n ~
Zomng -'\ A. 1 Y"
/ - 7-
S 40.00
S 55.00
S 80.00
volts see "B" above
New, Alteration or Extension Per Panel
"
One Circuit S 35.00
Each Addi tional
Circuit or with Service
or Feeder Permi t ~ S 2.00 L/. 00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7r. State Surcharge
J% Administrative Fee
TOTAL
not included)
s
s
s
s
~t~F-
t-.. '-1~
40.00
40.00
20.00
36.00