HomeMy WebLinkAboutPermit Electrical 1998-8-3
',..
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
, The: following project as submittodhas tho folio'
zoning, and does not require s"""""i1ic I""'d '
approval.' ...-- -. use
Zonina Ph:J
Dt'lteX/g J q'~
97477 . . l'
726j1~~IZed Signature . "'\
r.itv Job Number
ELECTRICAL PERMIT APPLICATION
9rfo9P3
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
IfGfJlx ,QE~og:PTI9NJ 0 I Service Included:
IUS.I- /3 '-f D);-, () MI ,~;\TiON:Oregoniawrequiresyouto Items Cost
~B DESC~YTION follow rules adoPted1~~ep~~ei.n ~~itks $ 85.00
. ~ ~r:rfJ/lR 12 ~ Notification Center. T291~ r~: A ~f_bo
In UAH tI::>~-001-001 0 t~\f.u9!'t ~ aY&~Ib~
Permits are non-transferable aae~ce.x~lt{flayobtaintH~~&o~ e ule $ 15.00
. if work is no t started wi thin 18eaklioQ3he center. @"!Q:W: lhfht&~~c:w.~e or
of issuance or if work is suspeljl}~mbefrdlOrthe Oreg<m>~~wrN~iPP1IPRg
180 days. Center is 1-800&aa-2~4~k Feeder
B. Service~ or Feeders
Installation, Alterations
Electrical Contractor~~~/~ f7~. or Relocation:
AddressH. ~X:;; ?J!h NnTI~E: 2001 amps or less
- 201 u':..f!1.l?s to 400 ~')1ys
Ci tyZ;:>C 2',u 7' Phone.~ t3 -1~~~T SHAtbf~e: IIi:~H~cWOJ:Mps
. ( .' . . ~~~IZED UNrn#t TfJI~~ER~lt~~()jffips
Supervlsor LIcense NumbeT.3 c/h' . " , .. 9ver 1'000 am2si'volts
/ ' U\It:i.!CED OR~8BANOONrtQ!t~R .
Expiration Date /CJ/I./PR' MIV1P.(1[;;\YPERIOO. .
,.~' ~at? C. Temporary SerVIces or Feeders
ConstrContr. Number f.Pl6 / f / Installation, Alteration or Relocation
1.
J,.OCATION O~INST,ALLATI~
/3/~ /7S~A) '::::>T,
2.
CONTRACTOR INSTALLATION ONLY
Ex~iration Date 6-c/- '99
s~~ S~O(l;;;:::ician
~wner~ NameXhool j) is r / '1
AddressJr)). <) /1I1d l 5;rrld-
Cit6r(;1;,~e(d. Phone 72-tr22lf~
OVNER NSTALLATION
200 ampg~T less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
Sum
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40..00
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
,.
One Circuit / $ 35.00 3~OO
Each Additional
Circuit or with Service )...60
or Feeder Permit I $ 2.00
not included)
Misc~llaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited EneTgy/Comm
The install~tion is being made on
property I o~p. which is not intended
for sale, lease or rent.
E.
Owners Signature:
----------- -C1~-..- - -,---,--------------~
DATE: I , JY
RECEIPT #:. I 1. 41....
RECEIVED BY: 'U.,A/ ( /\ _ _
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee.
TOTAL
$
$
$
$
.37 . no
/. '{'j
~
40.00
40.00
20.00
36.00