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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