HomeMy WebLinkAboutPermit Electrical 1999-7-30
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i-2J2Qri~]Fi'JI1aSTR.3LT - --...- NerICE:" ELECTRICAL PERMIT APPLICATION
" ;,'.. SPRINGFIELD, OREGON 97477 THIS PERM' .. a Ct
INSPECTION REQUEST: 'i26~37~TH ITSHALLEXP/RE/FTHeVV6Fllfb Number I It) r / y
OFFICE: 726-3759 ' "OR/ZEDUNDERTH/~PI=J:2ft.A
'~. 'COMMENCED OR 3 . cOm?IlliIfBS~ SCHEDULE BELOY
10 LOCATION 'OF ~NST,AL AL],.A" TIO~Y1BODA IS ABANDONED, FOR" '
jSrZ ~ l' YPER/OCA. New Residential-Single or
, 'Multi-Family per dwelling unit.
Service Included: '
C. Temporary Services or Feeders
Installation, ~lteration or Relocation
1"0
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'."1ate -
LEGAL DESCRIPTION '
11 ()S 3'(2-- 3 '
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JOBDESCRIPTI~ # d' . 1000 sq. ft. or less
, ,t~ VL.MA - Each additional 500
, .. f" r . sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started,vithin 180.days Each Manuf'd Home,or
of issuance or if vork is su~pended for Modular, 'Dvelling
180 days. Service or Feeder
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2. CONTRACTOR rNSTALLATIC)N OlfGl;}=NTI 1\1;0 ,B. Services ~r Feeders .
.. .. O.'?wru sad regonmSj~)J_atlon, Alteratlons
Electrical Contractor .Notlflcat' n~ OPtedb~1hJ'tj'1fU~a1Y'jjOij.-:
III G~1J'952-o 9nter. Those r; I ~egon Utilit~
Address 009~Yol' rn,.,~?-0010 thr(;~th ~fu"~ ~ fMu~s
ailing the -./ vbtain ci ~ fl;9~OO:OO amps
Ci ty nUmberfgr~enter. (Not rl' <Urhs r~~sg6~ amps
. C t= Oregon 'wi'e~fi~h~ReB~jOO amps
Supervi.sor License Nu enteris 1-800-3 ~t\rNOO~@at&I1JPs/vol ts
, , .e~3'f.1~c t 'oJ&ly
Expiration Date
Constr
200 amps' ~or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
, S' gna ture of Supervising El.ectrician
Ovners Name ciL/?/i A/? !?,J6?Z.
, Address rt()1'f./ ,I(~~~~ ,tfJ
Ci~y t~jJ<; /A/>// Phone 7t.7- 91 JJ
D.
Branch Circuits
New, Alteration'or Extension Per Panel
$ 35.00
OVNER INSTALLATION
One Circuit
Each Additional
Circuit or vith Service'
or, Feeder Permit
Items
Cost
Sum
$85.00 '
$ 15.00
. $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
I
$ 40.00
$ 55.00
,$ 80.00
see "Bit above
,.
$ 2.00
E. Miscellaneous (Service/feeder not include~)
-Each installation
Pump or irrigation .
Sign/Out1ineLighting
Limited Energy/Res
Limited Energy/Comm
The installation is being made on '
property I bvn vhi6h is not lntended
for sale, lease or rent,.
Ovners'Signatur~:
rJe~AJLuA". faJ~
DA~~~------~--"--'~~7!Jd79i~----------
RECEr"PT tj:: OS So S'q (7" II '
RECEIVED BY: (l\.-{ Wp.-J/
5.
SUBTOTAL OF ABOVE
1<JoState Surcharge
37. Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.'00
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