HomeMy WebLinkAboutPermit Electrical 2002-4-15
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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LEGAL,DE~CRlPTION
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ELE\""~rUCAL PERMIT APPLICATION
City Job NumbelOZ-oO YS/-j -CI
3. CO~LETEFEESCHEDULEBELOW
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
bmitted has the following
JOB DESCRIPTION The~Ol\o:.~~g:;~~e~~~~:~uire spOO~~ ~,~6?less
Add L 01-'\ /'5.,' HU,J '-1~lf!?i~lv- Each addItlOna~OO
Z 'ng l.JJf!--==~, ft VI ]YortlOn
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Permitsare non-transfe,ra~le and expire ..H.......~~,,::9J~I1~.Je.QL"-=
If work IS not started wlthlll 180 d!i>'ffle - .....d ~ach Manui'd Hmue or
of issuance or if work is suspende~.{5Hiorized Signature -'9"\' 'modular DwelliI~g
180 days, Service or Feeder
2, CONTRACTOR INSTALLATION ONLY
G'e~v-d Glec.T'\--\c
rla.4,de,..j 8.- 'R,J
Phone -'''--/,1 ~2SYt.
Electrical' Contractor
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Address. c"3 ld ,.
City -.J:p~ t<:l
Supervisor License Number 36$4 .s
Expiration Date J() -! - .2 f::><> 4{'
Constr Contr. Number. ? 7/tJS
Expiration Date J) --/6 .... ();2
Signature of Supervising Electrician
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.....J1 ~ C,;'YV...L;t........
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Owners Name 7511Y1. rlo ~t~,...J
Address :>: 71 ~OP7\l)" J-
City -sP F;~
Phone 741-7 6~ 1
OWNER INSTALLATION
The installation is being made on
property I o\'vn which is not intended
for sale, lease Of rent.
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Owners Signature:
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S~: OO"i- 8 I G83~ lW~
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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
tit,;':, 'l'itReconnect Only
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:Ie'! l'::."I. '-k ~~t.~
.-.<~(} " '~{;,~
Jw.~~,;~,~i&1e,s or Feeders
. or Relocation
D.
Items Cost Sm:n
$106,00
$ 19,00
$ 50,00
$ 63,00
$ 75.00
$125.00
$163.00
$375,00
$ 50.00
$50.00
$69,00
$100,00
One Circuit
-'- $43.00 43
Each Additional Circuit or with Service
or Feeder Permit b $ 3,00 I €
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump 'or irrigation
SignJOutline Lighting
Limited Energy/Res
Limited Energy/Comm
$50.00
$50,00
$25,00
$45,00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
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70~