HomeMy WebLinkAboutPermit Electrical 2002-6-27
.-
225 FIFTH STREET · .~. .(\. 1 .~tJC,~ .
SPRJNGFIELD, OREGON 97477 \'=". ~ ,,-
I INSPECTION REQ~ST: 726-3769 b~ ~
OFFICE: 726-3759 ',:,~'W: ; ,
"oIi ",e CO
I. LOCATION OF INSTALLAIl~~,eo.~ .
~'?~. ~lJP.jJ\~..-r""
o~() i'O~o /'
LEGAL DESCRIPTI(i)~:,,~,.~ ~,,~
I 7 " 3. z. b 'f l.,o ,,0.,0 0'/ '-f . ..e
...' ./ r:;.,~<!>'-
JO~ ~ESCRlPTION ...", ,."0. _
<.ftr(Lj!, G? Co},; I.~ >:./ C~
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwclling
Se,,,ice or Feeder
ELEaCAL PERMlT APPLICATION
en.o 071) -C I
FEE SCHEDULE BELOW
Re,idential-Single or
Multi-Famil)' per dwelling unit.
Sen'ice Included:
';'~
Permits arc non-transferable and expire
if work is not 'started within 180 da)'s
of issuance Dr if work is snspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B, Sen'ice, or Feeder'
In,tallation, Alteration, or
Electrical' Contractor (~IOO:Oregon I Relocation:
follow rules adopted aw reqUIres you 10
Addless ,Notifi"".tian.C':;f,:.:.. T by the Or(l\lllllll~lwyess
, m OAR 952-001.0 ' hose ~u/eS1l)iI9<wmSf!5l-e90 amps
Cit)' . PJl3ll\\l v-"rr;- _010through0.4,1R9~f.9oamps
, ' caWL .2~ri vu,am copies Of~IlMI'b!POO amps
Snpervlsor License Nmnbqlt~~nt enter. (Note: the t~tlBR amps/volts
I..} ""'_.. v, "''': 0regon Utility MSTfti'811ffo,?nly
Expiration Date ~v Centerrs 1-ROO-33::>.23<141
,.. ./ C. Tempoi'al')' Service, or Feeder'
'. Constr Contr. Number In,tallation, Alteration or Relocation
'.....Expiration Date
200 amps or Icss
_ 201 amp' to 400 amps
Signatnre of ~upervising Electrician ~@'i\~~~~ . -. Uf\iO~~~~%~~~~Q~~s sce
\S PEP-W\\"{ So ' 'm\'S PEP-WIll \~'\I!
1\-\JKOP-~EOUNO AQhNOONEOfOR ,
Il.A "",. ,I AU t:.\I!Ct~\?n\lil~'ir, .
Owners N ame ~ IrI Alil ~W\~O rlll.'/ PEmQQ\lteration or Extension Per Panel
1\~'l18 Y. I
Address 'PIO, e~ 91'..., One Circuit _
Phone 7'-1I-i77b
City~pr .
ltems Cost
SUI)! .
$106.00
$ 19.00
$ 50.00
$ 63.00
$ 75.00
$125.00
$1r,3.00
$375.0n
$ 50.nO
$50.00
$69.00
$100.00
$43.00 If>
Each Additional Circuit or with Service .,(
or Feeder Permit ....z.. $ 3.00 ..J2..
i\'1inimul11 Electric Permit Inspection Fcc is 545.00 + Surcharges
4 '7.oc)
,4. ~-.::>
.'3 J\ ~
.5lo .55
OWNER INST ALLA nON
The installation is being made on
property 1 o\vn which is not intended
::'?iliI~
190:~3IH8~8 ~ C-J
:39N~HJ ~ .
L~'69g $ 0:a83~ lW~
;:000 a Nnr:31~a
99L6000-10:#8N~~1
E. Miscellaneous (Sen'ice/feeder not included)
-Each installation
Pump .or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited Energ)'/Comm
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Admini,trative Fcc
TOTAL
$50.00
$50.00
$25.00
$45.00