HomeMy WebLinkAboutPermit Electrical 2001-7-5
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
2. CONTRACTOR INSTALLATION ONLY ,B.
Electrical Contractor m;id-ls Ez;Ct,mt' 1i../
~c.
Expiration Date ,/0- 0/ _ c) \
Signature
Electrician
JJ?1.
owirs Name ~u tt-.....
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Address '53G7 f}~ hu 5.'O~ ~
Ci ty S {J/.,(J ~, '17t,7--!hone
I
OVNER INSTALLATION
The installation is being made on
property I ,own whi~h is not intended
for sale,lease or rent.
Owners Signature:
---------------------------------------
DATE: ' 070 ZJ c::> I
RECEIPT ti':
RECEIVED BY: }\,((
r /"\ <~
19V ~ ~
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ELECTRICAL PERMIT APPLICATION
City J~bNumberOO.~O/3S-~;.-Q' r
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
Sum
r-
O~
S- ' $ 15.00 '7><;
.$ 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"oT less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" ahove
D.
Branch Circuits
3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATIOlthe following project as submitted has the following
~q 7' (-/w\bl-f''"';I)?Y ()~ <;~ing~ElP9S'trJGfrQ\1vireN~ifiR~d@fHial-Single or ' ,
- . . - approval. i fllf Multi-Family per dwelling uni t.
. LE, GAL DESCRIP,II.2r ,_,~o",n!.Q~ ,VV '3~~ ~~~ded:. ,','
,-; () 7_ I '7~ ;Q~{)()! 'l~ ,,' " , Items -' Cost
JOB DESCRIPTiON Authorized Signature M~=i' :.:. ar less I $ 85.00
_fub(?f:l '7Vt..~ ~ t;/kt.A'Y'-l-A'/" .fjg5EOc-K Each addi tional 500
, ,sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home. or
of issuance or if work is suspended for Modular 'Dwelling
180 days. Ser~ice or Feeder
,.
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with ,Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
~')
$ 40. 0.!1.:
$ 40. 0'0-1 t:::I :;a
$ '20 O::;(l:r..::-.......-
. 1\111 --t :z::
$ 36 d^1 rrll..'.'
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