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HomeMy WebLinkAboutPermit Electrical 2002-8-15 . 225 FIFTH STREET ", e\ SPRINGFIELD, OREGON 97477 , INSPECTION REQUEST: 726-3769 OFFICE: 726-3759, , , ELEaCAL PERMIT APPLICATION CityJoh Numher62-co 96 ?-o ( i '1' ; , . 3, COMPLETE FEE SCHEDULE BELOW L LOCi\TIO~INSTALI;A:RO~~ );]'y,; ~ /71)' k"OL)L/'k CfJLIC<.e' (q< A, New'Rcsidential-Single or Multi-Famil)' per dweliing unit. Sen'ice Included: LEGAL DESCRIPTION r /O:s Z<{L{3 04600 , d has thO tollOwing , ubmltte ... sa JO~~SCRII;'yION /thet.,iow' p,olec: r: uire spacitic la""t'I><l,ft, Or less /-II L HYtwa ~ ~ Each ad~ional 500 . approvaL --L..D ~!j. 1. Vi portIon" Permits are non-transferable and exj2lroing .,~O ').- tl if work is not started within 180 days <6 '.5.. ~ Each Manufd Home or of issuance or if work is susPl!ll~eafor, tu,e !vlOoular Dwelling 'dSlgna - , 180 days, AuthOnze Service or Feeder Items Cost SUn! $106,00 $ 19,00 $ 50,00 2, CONTRACTOR INSTALLATION ONLY B, SerTices or Feeders .' Installation, Alterations or Electrical' Contractor Ie'. ~ F';( e dfLt.e, ) LV'(ljJL :1k'Relocation: Address (jJ, 0 ,16UJL 2J('iJJ / City 9-u f~ Phonefo~C/-'0).Jb Signature of :Supcn'ising Electrician ,- , /200 amps or less $ 63.00 20 I amps to 400 amps $ 75,00 401 amps t~ 600 amps ~ ~,1,25,OO_ 601 amps to 1000 al~pS'a" ,.CQU1f::S yu:JJI,B3 ,00 _ Ove, 1000 amp,s/v,6,liS" ,;"~Or3:l011 U'$,39?,.OO_ , I ...... "'. '0\1 Ll' - '~&$~OS'O 0' 0 Rec9nll\",lPWYJP' ~_: '~'" ru\aS ,;re "::, 0"'- "Ic" ..\. "J"" f\U~. Of\f\O"?"O \ ": ~t_,_,T'-' ,\ \ (~B;ll ~. n '~:\'"'I\jf\\' f ..... ......c- b'" . C. TemporarY'Servrces,ot)Feeders" \ \l1e ;uk~ ' .' ........0 .::":~'-'\_'U '. - , '"'\n\(."S J. . G InstallhtlOn, ~ltCrHhg~{pr1'RelocahOI~, ye\znliOi' :.;S(,'(GI! "W.:er,\l r. ~Note: ~11~, NO\;\\catiOI" 200,ii\i1/lslb'i'less C,E:('nn \ l\\\\t~ ,..',\ $50,00 - ..~,.. ~'lf.mt. ~ '""'2..t)~~ $ - ~9J:amps~o~VQ,a!llps"lr.O"- . _ 69,00_ -..-O\'er401 t0600'ail1ps $100,00 Over 600 amps or 1 000 volts see "B" above . Supervisor License Number -3 '(j q 7 " ., 10///01./ Expiration Date ./ "Constr Contr, Number 7 hk,fi '1 Expiration Dat; ;):.../'1/JIO'-/ ~6\ \t:> ld~vi)f/ , Owners NameKc>i3l"rf J MfiL Address c2/76/)4A.rL. Cr/'/afl 7<t Cit). S 6 L,4 Phone '7L/7-SJ/f D. Brauch Circuits New Alteration or Extension Per Panel One Circuit --L $43.00 Each Additional Circuit or with Service or Feeder Permit -L $ 3,00 OWNER INSTALLATION The installation is being made on property I O\VIl which is not intended for sale, lease or rent Owner.s Signature: ~ot\C'e'cellaneous (Ser'\'ilf{~W"ffl~tWm\~d) 1\1IS PER41~~\tIj:l.~~~b PERMIT IS NOT ' $50.00 ~Ul\10R\Z~~~~'~~e;<<!t\\1l\lg)NtO fOR = $50,00 = COMMENlt~i 1l'l3ilRes _ $25,00 _ ~N'( 1 BO Oi't.'(i \: Nergy/Comm _ $45,00 _ . T~C: ~:J fHSl~-j .t:':J ()~ _'~; ~, L 'CI~~~' :.:y 3CnZ ']T SLi~~ :.'.t:~ -:0\:[ T:JO-,:O, ;'8;~i:Jl l\linimum Electric Permit InsJlection Fcc is 545,00 + Surcharges TOTAL 1ft :>u. 36lf 52 90 4, SUBTOTAL OF ABOVE 70/0 State Surcharge S% Administrative Fee