HomeMy WebLinkAboutPermit Electrical 2000-9-1
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225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 . . sthefollowing /
INSPECTION REQUEST: 72'~~lM'ingtOlect ~~:~~i:ttsepde~~iC land ustCi ty Job Number 00 -0 (s s'-f - 0
OFFICE: 726-3759 zonlOg, and oes no
approval. ~ -.A
. ~~~ 3. rOMDTvr~.PEE SCHEDULE BELOV
1. LOCATION OF INST~LLATION zo~mg 4"... I .. ~@ _
3(0(7 AVVlble.-s it1~te D,-'ve ~. New Residential-Single or
Authorized Signature Iluld-ramily per dwelling uni t.
Service Included:
LEGAL DESCRIPTION
! 70'L3e>ba
oo6:f::) I
Items Cost Sum
1000 sq.ft. or less $ 85.00 g~4()O
Each additional 500
sq. ft or portion I-l foOr 00
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
JOB DESCRIPTION
WVtOI-e Vl0USe W~(' ('V! r
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
Services or Feeders
Installation, Alterations or
Relocation:
B.
Electrical Contractor!-,ft: E(t:'L-t('t c
Address rpO Box (0g to
Ci ty-.&LLb ()J1J-4-!hone,)Cf/-1fp7. ~fo7.. 7
Supervisor Licensecttimber::Jq ~ 5
Expiration Date / (j - I - 0 1
.Constr Contr. Number. 5 Cj Lr Co g
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
.
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
/() -/-01
Expiration Date
200 amps or.less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
'$ 80.00
volts see "B"
Signature of Supervising Electrician
X~ ~(LLQ.
Owners Name 2t vc-rL J M~ {(A-: (~'" D.
I . - ..
2-0'-f (
Phone 72b "-0"330
above
Branch Circuits
New, Alteration or Extension Per Panel
Address ~ ~ 9<
Ci tG(LV A--( V S
One Ci.rcui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
OVNER INSTALLATION
$ 2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
not included)
$40.00
$ 40.00 D
$ 20.00 ~ -i
$ 36.00 ;u:i5$
n-; : z:
c-J JTI (.1')
5. JUBTOTAL OF ABOVE /'-15 \~ rI; ~ ~
7'% S ta te Surcharge, I fh.~- ~ '"TJ ~
TOTAL 3~ C{~ F-U LI .~~~g
7ift~ /s~~ag~
r- .. '-' <:..J ".)
Owners Signature:
---------------------------------------
090100.
"'30'12
'D~
DATE:
RECEIPT #:
RECEIVED BY: