HomeMy WebLinkAboutPermit Electrical 2001-3-6
1
DATE: MAR 06 2001
AMT RECD:2 $ 40.70
CHANGE:
CASHIER:003
ELECTRICAL PERMIT APPLICATION
';ity Job Number tJ!-()/)/.B0 -(J i
3. COMPLETE FEE SCHEDULE BELOY
:he following project as submitted has the following
1.(/l'lIng and does not require specific land use
a~proval "
Zoning . J..))f'L-
~-(p -Dl'
~~
.
225 FIFTH STREET ",Ie
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: '72'6~':Y1699nature
OFFICE: 726-3759
1. LOCATION ~ALLATION
-----L/8 3 -r . !..UJ&B I../AJ 0 A.
r
LEGAL DESCRIPTION
/7//< 2-\2./ 0/&;67)
/'fOil DESCIqPTION / , / -0
--1::i.Li H>A.u!J I ~.-t/ fL-IeA:iT /LL!f(f
Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
.
2. CONTRACTOR INSTALLATION ONLY
Electrical contractor}::.r E/ec:!;' 'r
Address (j7. Q . rg cJX. L '/9 J1
Ci ty_ ~,~tt.?-nr'../ Phone C. ('-b-t-d3'
Supervl!>or License Number 3 ~9 7,j
/0// /#~
I /
Constr Contro Number "7 Oo-if 5'
/ ~/jtJ/Od'
~ature ~;.upervising Electrician
1:~I.~ If" ~.~ .-'
O~ners t:mefu iY;;;;s /tArOL
Address~ / 1?.4MBLJ~G
J
Ci ty S'/; ~ Y.7 Phone 7'17 - t, 370
OYNER INSTALLATION
Expi ra t ion Da te
Expiration Date
Ne~ Residential-Single or
Multi-Family per dwelling unit.
Service Included:
It ems Cos t
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder .$ 40.00
B.
Services or Feeders
Installation, Alterations
or Relocation:
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c_
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
fIle /YJa.Iit tvW
New, Alteration
The installation is being made on
property I own which is not intended
for sale, lease or rent.
. Owners Signature:
DATE~-------~~-::~:-2i~--------------
RECEIPT 11: -f-In (I..
RECEIVED BY: A?"/ ff~
lk '
$ 40.00
$ 55.00
$ 80.00
see liB"
above
"
or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with service,
or Feeder Permit ~ $
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
-L
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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