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HomeMy WebLinkAboutPermit Electrical 2001-3-14 Mar-14-01 IO:34A . "P_~'''L'' P.oz 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 f)ate 9747-7."'0,"Z90 Signature 726-3769 1. LOCAT~ OF INSTALLATI9tf. '.1 Iflll 1-1.e"c...<.:...cu'\i.:\, , LEGAL DESCRIPTION JOB DESpRIPTIO,N . --f) -~ In \ f l'...e_C.ldd-LJ ':fox perm:ts are non-transfe~le and expire if work is not started within 180 days of issuance or if work Is suspended for 180 days. 2, CONTRACTOR INSTALLATION ONLY Electrical Contractor"12I//){)/d~ 'rJprl,;e.., Address~Jc;:::) Ij'l ;;l 00 tl1le . Ci ty~'C!9fW Phone3L~=-lliJ () Supervisor License Number ~~~ Expiration Date ID!()\ (C\\ Constr Contr. Number \~~~~ Expiration Date rl-'~\D~ Signature of Supervising Electrician ~-~-5 ovtfls Name-L^ v-....\(~Tf\~\<t_ Address City Phone OllNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: 1:m: ;~rm-lgW) ~5~~~H~~~~~-~~~------------ lOOG ~~~y: 899~OOO-lO:#SN~~1 275 ~IFTH STRFET SPRINGFll:t n. OR 97477 (041) 726-3753 FAX (541) 126-3689 lI.L.11l..uu.\AL PERKIT APPLICATION City Job Number-DI -cP~33-()) COMPLETE FEE SCHIlDULE BELOtI mil 7-1'-/-01. M 3. A. Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less , 201 amps to 400 amps --r-- 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only C. Cost Sum $ 85.00 $ 15.00 S 40.00 S 50_00 S 60.00 $100.00 $130.00 $300.00 $ 40.00 ?O..~ Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 100v volts D. Branch Circuits Nev, Alteration or Extension Per Panel $ 35.00 One Ci rcui t Each Additional Circuit or vith Service or Feeder Permit E. Kiscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 7% State Surcharge 31. Administrative Fee TOTAL $ 40.00 $ 55.00 $ 80.00 see tlB" above $ 2.00 not included) S 40.00 S 40.00 S 20.00 $ 36.00 &::.[) 00 .... :>v - -J ':)0- --5-5.. Df)