HomeMy WebLinkAboutPermit Electrical 2000-11-2
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DEVELOPMENT SERVICE~JJ~1!fAgTMENT .-Cf'
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A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included,: ,<(H,< h
.- f r;,,,,," :1;~J' ':;. ~.. ;I,t
__. :,: "~, .~)"; ,"::'~:', v ~ ,oreoorl uti,' . ,ems
,-,' I ~' , rlC\o1er '0\1 JI€ "-e1 tc ;
JOB DESCRIPTION tallOW l'U\e~ }00Q,.' s\Q'iCfs1;;.fU0.9:-5:. [H~~~1; 2-1\\ 1 \.
If:: I0ItAlT Sj,AAPR~ uE.. ;z,ze~T ~ !C}tilicatiO~\ CE:f~h'oae~I~TbiJ~~ls2~I\e~ Cly
. . n OAR 952-0~1i Yhlt~n ef)pP':'0]~flhn3n . 1\8
Perm ts are non-transferable and expI,rcr90 YO\.lt1lt.'t\h~r~ofNote' tnete\e.p~o" ,',
if work is not started wi thin 180 day'~ a\\inQtPEaG:lfItMk~u:nJli\fi9ine)t'~lpo"~
of issuance or if work is suspended fore b;rtotM.od&,]Jc'i?~~~~lJing' \,
180 days. I1Um (c-,servTce or Feeder
Electrical Contractor IlvrUtJ(TyGL{Cf
v
Address ;)J]:2'2- IV c.. 1</HN{;,D.v;en. 200 amps or less
201 amps to 400 amps
Ci ty R, IJ~ ~ rff&1 ';;'<4!, Phone503 ~.;]D 1-0 5'.? ~"I or,C2f.c)'J. amps to 6P.:R:: \fm;w~.:. WOHt\.
[Jfr . CJj~ hb6 \ nE6.Q~Ta;IiJ'F>'8...LtFe)(1l500 amp,s Ie.:. NOl
. . /0 C"J r'" '\ ~\S r qllll'~ -. .ie nCiMl\i.I! -
SuperVIsor LIcense Number ;2(P ~ '7 .:> \ r ,. Oyernh~~St.\<FQPIs:;ZV0Its__
, I I ' !l~,m-\OR'el~nnectc.On.1.~"'DONEDrun
Expiration Date /0', 6/ b I ,t\Jliv~ENCEDOR\,,,;l-\lj,
... , 'C~ T,emRor-a;.J!'..y,CS1lrvices or Feeders
ry "l / / C1 C <'t ~f \ iJ,\ t \ '-'
Constr Contr. Numb~f ~ ~~~' {- '~nstallation, Alteration or Relocation
Expiration Date / () ~ ( /0 I 200 amps or less $$ 40.00
;' , 201 amps to 400 amps 55.00
Signature1Pf S/perVis~ ~~ctrician Over 401 to 600 amps $ 80.00
.~ ~~_~ Over 600 amps or 1000 volts see "B" above
~/ D. Branch Circuits
Owneri/Name 5t.f r,~ "B
, I l)~ .1, . h J New, Al tera tion or Extension Per Panel
Address ..')405 17o.lal . 'Vvtft<..lX
City ~pr~~~\~PhOne
OWNER INSTALLATION
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
97477
726-3769
1. ~OC~ION jJf INSTALLATION
o 0(5 ~l3.LTL{,vL
LEGAL DESGRIPTION
Iro~15U') 0 ~4(JQ9
2.
CONTRACTOR INSTALLATION ONLY "
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
DAT~~--I~T;l~~------------------------
RECEIPT #: . 36'~ 0
RECEIVED BY: MY,))
3. COMPLETE FEE SCHEDULE BELOY
B.
Services or Feeders
Installation, Alterations
or Relocation:
f
One Circuit
Each Additional
Circuit or with Service
or Feeder Permi t Jt/
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60. 00 .
$100.00
$130.00
$300.00
$ 40.00
5lJ~
$ 35.00
$
t"/ ~ IJ 0
2 . 00 t7f 0
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 7 $?~
7% State Surcharge 5,~6
3% Administrative Fee ~.$6'
TOTAL 85 J! ()