HomeMy WebLinkAboutPermit Electrical 2000-7-19
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zonmg, and does not require specific land use
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Date
225 FIFTH STREET kJlhollZed Signalure _ ~
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION Q
S'/f ,~ OrfL~CL- ~j?;::"(...jJ. A.
LEGAL DESCRIPTION
1703 'Z'3'l3 C>l..\oz..
JOB pESCRIPTION ('
/) .II- c. U.-IA M ()J -fe'T ~At
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
ELECTRICAL PERMIT APPLICATION
. . .
City Job Number.pt1 -c1() 7?;< /!/
60 - 0 IllS - 0 I
COMPLETE FEE SCHEDULE BELOY
3.
New Residential-Single or
Multi-Family per dwelling
Service Included:
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 ONLY B. Services or Feeders
() ~ ~ Installation, Alterations
Electrical Contractor _ E/V~ /If t?)ltu~ or Relocation:
Address /t?- 6~ "'rr'6' ,f('~mps or less
/B . 201 amps to 400 amps
City L!,;::'c~tVE.tC- Phone 'if? 7;Z ~t:q 401 amps to. 600 amps
601 amps to 1000 amps
Supervisor License Number Over 1000 amps/volts
Reconnect Only
Expiration Date
Constr Contr. Number () 'b 1'Cft(()
Expiration Date -V -1'7 - () 1
uni t.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signa tVf; O/S::It)a:::ctrici,an
-/ ) .$ (r-- - . I~ D
Owners Name 1<-- I,(/YK;C /0 /)OP'r~S-
< ,
Addre~s
City Phone
OWER INSTALLATION
The installation is being made on
property I .own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: 071'7DO
RECEIPT II: Z-bW
RECEIVED BY: .l',(<:'
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see lOB"
Branch Circuits
above
o'
New, Alteration or Extension Per Panel
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 I
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.0~ .....
$ 20.00"' ~~c>"'-!1.
$ 36.0W,;:;:fii
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