HomeMy WebLinkAboutPermit Electrical 2000-1-13
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9
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AHT RECD:2 $ 22.00
CHANGE:
CASHIER: 004
The. following projecl as submitted has the fOllowing
zoning and does r.ol requirE: specific land use
approval fZ-.
Zoning ,[])
Dale /-1":$- <TV
974t!I'1orized Signalure c:::r( J
726-3769
ELECTRICAL PERMIT APPLICATION
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
l.~ ty Job Number ~.~Jt?,eJ..;,t!:>}
3. COMPLETE FEE SCHEDULE BELOY
LOCATIO~OF INSTALLATION
qos nifni d/l/p,
LEGAL DESCRIPTION
) '7.a '3.2"'3l./ ~ . ;:2. /.&>"2.
- ,
L
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
A.
Sum
Items Cost
$ 85.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Rome. or
Modular'Dwelling
Service or Feeder
JOB DESCRIPTION
SIt't1vihi S,'11Kb YltL
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
$ 15.00
.$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
.B.
tllr""M~
2. CONTRACTOR INSTALLATION ONLY
Elec trical Contrac torO"'r~; D,'pri
Address.Q.O. fhox L/O'5L/i
City ~/Iqfnl' Phone 1'fi.JI't./'lt./ -Q01f
Supervi$or License Number ,~~~I JJ1;
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Expiration Date 10 lot.
Constr Contr. Numb~ 49./LI5
Expira .' on Date tJ, ( 00
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
./~
\.J'" . ~.;.
Owners Name ,,.,./ /lIP (7; H Of'" I/Y"
Add ress P.O. ~/}i 1 t/? fj
Ci ty 4/111 P 11 p~ Phone 1Lfi./ -2(; (0 D
mINER. INSTALLATION
Branch Circui ts
D.
.'
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder.Permit
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lightin~ S 40.00
Limited Energy/Res $ 20.00 ~
Limited Energy/Comm S 36.00
5. 7S~BTOTAL OF ABOVE -1.(1 ill!
" State Surcharge j ,L/Q
3% Administrative Fee , /;()
TOTAL t 1 ' ()t"J
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: 1./'"':3~
RECEIPT II: ,'~3"'i30
RECEIVED BY: /" /'--;.;JJ ..~-
'- ~V' ;~