HomeMy WebLinkAboutPermit Electrical 2000-1-18
.
SP.FIELD
4
DAT,E:JAN 18 2000
AHT RECD:2 $ 22.00
CHANGE:
CASHIER:003
The following proia t
zoning and does ;',,~~:ubmltted has lhe fOllowing
approval . qUire specific land use
Zoning -.!:J)/-
225 FIFTH STREET Dale /-/5-- /T7)
SPRINGFIELD, OREGON 97471. .,..;, ~ 1
INSPECTION REQUEST: 72b-'1med Signature. 7)'k./
OFFICE: 726-3759
~u,;l-TtUCAL PERMIT APPLICATION
Ci t1 Job Number ~ ~//~~.~ /
3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION
~ ~.A'./ "?)#L
LEGAL DESCRIPTION
J?~ 2""3 t.,.I ~ ':::>.2Je;:>2..
"
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 Home. or
Modular Dwelling
Service or Feeder
JOB DESCRIPTIO~
( tj;1#[,7 (,~t{n:'A 4F
~i ts ~~s~fd"""~d expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY .B.
Electrical Contractor &~ ;:;;~a".J
Address ?k2 9 tA~")~/Yld .ktJ)'"'"'"_
.
Ci ty ~f'/?tJ Phone tV7-3IP-I
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
$ 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
Supervi$or License Number
Expiration Date
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
$ 40.00
$ 55.00
$ 80.00
see "B't above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Signature of Supervising Electrician
Branch Circuits
D.
~ /' -
Owners Name:l~ ~:hrJ
Address U2'7 ~FNMu7Vf A1/l"
Ci ty (f',.?1) Phone "7'f'7~ 'i'/:;-'I"
"
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Addit ional
Circuit or with Service
or Feeder Permit
$ 2.00
OYNER INSTALLATION
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00 ~~
Limited Energy/Comm $ 36.00
5. ....../1."'-
SUBTOTAL OF ABOVE -~.
7% State Surcharge J . ~o
3% Administrative Fee .~~
TOTAL 4.2 .6 C>
The installation is being made on
property I own which is not intended
for sale, lease or rent.
77J~
----~--~~~--- ---------------
DATE: I-/e.~
RECEIPT #: /7ttJ~f!2~
RECEIVED BY: /' d/.A~-'_
-~ PLY