HomeMy WebLinkAboutPermit Electrical 2001-1-8
The fOllOWing ro' _
Zoning, and P Ject as sUbmitted' , ,
apprOVal' does not require s e h.~s the fol/owln
225 FIFTH STREET ~ . J P ClflC land Use ~LECTRICAL PERHITAPPLICATION
SPRINGFIELD, OREGON ~.7 4 77 on/l)g _-<.1) f2- "
INSPECTION REQUEST: -m~ / -1_::..011 - _Ci ty J~b NumberO 0 ' 01 'S S-'i.;" t!.> (
OFFICE: 726-3759 AUfrlorized S' --..t4 I _
Ignature IU 3. COHl'LBJ..ti FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION --
~5.3S'i(' J//J1jjl..I/'(r"t:Le- ,A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
/702. f7'fs
og:5C>:::>
, JOB DESCRIPTION
J""'rf'-U/d-./-( :%?1W~ ,I I;" fh Zt.u;t e.a..ua~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Items'
1000 sq.ft. or less
Each additional 500
sq. ft or portion ,
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
n . t - Installation, Alterations
Electrical Con trac tor')--)t' "!fYl-OJ d....l~ I f1t!-+r~/'lLc/p"r Relocation:
Address PO. Aox LfO_?c..f<j( ,200 amps or less '
, 201 amps to 400 amps
CityJ:u,()I/7/ Phone 5~/-1..1'8t/- 9tJJSl' 401 amps to 600 amps
I ' 601 amps to 1000 amps
Supervisor License Number 3_~ 31 .JLC Over 1000 amps/volts
7 Reconnect Only
Expiration Date' ID tJl
Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number /tf'itL3'5
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date &-/oV
"ffTl?t~7&t~ Rlprtr~an
v-t ~ -
Owners Name_O (1(0';' r "Q Ubk (' f)l))(I-.
Addre~s P. tJ. t3l?X_ -7-10115
Ci ty ~fLJ L Phone 5<{ I-,lL{ 7: -37 3D
OVNERINSTALLATION
The installation is being made on
property I own whi~h is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: Of 0 ~O (
RECEIPT #: 1..-/ \ 9 '-(
RECEIVED BY: J:J((
200 amps"or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
New, Alteration or Extensisn Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder'Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res ~
Limited Energy/Comm -
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see "B" above
,.
$ 2.00
not included)