HomeMy WebLinkAboutPermit Electrical 2000-11-17
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appro va) . n .
Zoning 1...\)1.....
11-17-4'b
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~"-ECTRICAL PERMIT APPLICATION . .
City Job Number (J 0 - 013/ 0 ~O{
225 FIFTH STREET
SPRINGFIELD, OREGON 9791~
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759 Autnor".o :"y'''i'u,c
3. COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION
f?/7 Il/J~d/ /Jd /a~~
LEGAL DESCRIPTION
) +o~;)~43 O'd../Od-...
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 DESCRIPTION
/,/J?A'U.d. R./?.P./f'f/S-"&.LrLh( "7f7/tf'b/l.--.-
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
.$ 4().00
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
II " Installation, Alterations
Elec trical Contrac torJJ/vtfiaj;fnf !PI 'bHtJ/l~tn',/IU'Or Relocation:
Address p't). /?;OJL VOi)iI-'X . 200 amps or less
: 201 amps to 400 amps
City YULq't/1L Phone 4<11. <f<f:tf.9o-1'it' 401 amps to. 600 amps
601 amps to 1000 amps
Supervisor License Number 33.3)Ji.-'Z-~":: Over 1000 amps/volts
',7 P'=C" r'c' I' fl.~connect., Only
It.; 1-1 II;, . '_'. ._. - .
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
/670'2
Expiration Date
,-,,"- -;,L:cJC. c'Temporary Services or Feeders
C" ':""-,('" InostalJation, Alteration or Relocation
I,',
go ",
Constr Contr, Number
1'=', J.) r,..
$ 40.00
$ 55.00
$ 80.00
see "B" above
-200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Si...tliK~7!iA
Owners Name~j/" A ff/1}1~
Address IJ. /}. jJw./ -; "" 2.5
trician
Branch Circui ts
D.
.'
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
City fN'9,,/lP PhoneJ1'<!t-;1t.,/</-;:'t,,40
O\INER INSTALLATION
$ 2.00
A'-~~~T~iscel~a_n_e2~~_~S~rvice/feeder not included)
fnll " " ,,;;.EiiS;h tnstapatioiij~'~:'4:l
0, , Pumpr;;r cHi:igati"oh)r> U';":" $ 40.00
, 1.\." Sign/Outol-ine,lI:ighting, . $ 40.0~
J:',- /"'Limit'edEnergy.lRe.lUs-_d $ 20. 00-< ~
il" \ [Ii L'" t 'd;'E IC $ 36 OClO~
... ~ ' 1ml. e '" nergy' Or:nm."'1hc.-....., . l"T1 rT' t......
CC..,I't I' - ,_ ~ C"J .. #:
_____________ ,5. SUBTOTAL OF AlioVE:'~'C'.13 ~ ..2~so
" ' 'Illca^'or ' - 1ItfbV''-o<' <".....
7% State Surcharge' 11, I~... '
3% Administrative "Fee ~, -.J 8
TOTAL _7-2. ~ '" ~ ~
U11T100~
....0..00-::1
The installation is being made on
property I ,own which is not intended
for sale, lease or rent.
Owners Signature:
DATE:
RECEIPT I:
RECEIVED BY: