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HomeMy WebLinkAboutPermit Electrical 2002-11-13 (2) .'5'....~. . . '225 FIFTH STREET ;..,;' ' . '. \,,".'" I I SPRINGFIELD, OREGON 97477 L " ., ", ,'1< .,,,, . INSPECTION REQUEST: 726,3769 .. . 'j, \ OFF]CE: 726-3759' . i . l I I , I " " ' I' " , ,. : ~ > I LOCATION OF INSTALLA.TION L ' j' " ::;?. <; ~J . k:'; <; T\,.", '<<'_ r' ~- .,' ,'. . ELIi.CAL PERMIT APPLICATION ":, ", '::, \" ',"', ", ':;,' .' , 'Clt;;Joh ~il~hCr eZ-,E'2Q:':)t..:.,; cO rSS '.' . '~ \ " , : ~ , " " '3. COMPLETE FEE SCHEDULE BELOW " ' ~ It. :'., A. New Rcsidential'Singleor" ,.... ,n ... ,Multi-Family per dwelling unit. LEGAL DESCRIPTION Se~Wi'dllcIullell: 170335)'2- 6Z700 s\"'.\~\ls. ~"ecj n~,\C \3.(\ c,\lbli' ~eC\ . JOB DESCRIPTION. ,oc\ .'.' C\\lll. S 1000 sq.ft C. C l' V / C f't-w1<P (&l<t>'i'"gS~~~ 1f E, ,ditio . " '1"'.\"g. .."" sq. ft ortion Permits are non-transferable and l!-~~~'fe\la\ \f\<;} ereaf if work is not 'started within 180 d~~ 1-0" " anufd Home or ofissui.1nce o~ if\vork is suspended for \'J'" ivlodular Dwelling . ~ ~ . ] 80 days. , tJ" ~.<l SI ServIce or Feeder .11' ' ~u\'{\o~' 2. CONTRACTOR INST ALLA TION ONLY B. Services or Feellcrs { r < Installation, Alterations or ElectricaI'Contr~cto:~(G>6 4-' ''-ft.Uv 11J.. - Relocation: /' '. . . Address 'l..{( i. Lv v ~ >L,r; .~~ _ 200 amps or less $ 63.00 C' . \, ;. . 1,/";/" . . "', 201 amps to 400 amps ' . : $ 75.00 .CitYCU7....:....;.~ .Phonc 6.'-t'6/-7<?S'7.;-\j.~lla~IJ)P"JQ\60lX\iiil~SYOU,~O, _$125.00_ I '. '~" . /". '4\ 11;:.1'1,\1..:1 ~P\~lJIUY4t!1l(1ll'1illilSnUtfhty ~$163.00_ Supervis<lr LicenspNumber /;).6,?-: (11tMJ..9I!/. r;t ett lk'r: 'WIl.91ill'1RMvgllSre set forttl,_ $375.00 _ , : ~ . '... 'oj' . .' l\1outiciatlOrl e 5",i~5'1'i\&lul"" OAR9~2-001' ~ $ 50 00 _ ExpiratioIl Date l(j--() /-2.0D'5 :r'tOA~~52-00" 'V~ai \coPi:~oftherUles by . . . , ' \)090, ,<9.\.iJ"11!lpJrrgf' ~(\l(ji&~~.I?e It~:$'r,{)~e "Constr C<lntr. Number (.., q ') f1 '5 calling fin~nRh'nli,\\"l'(cnlli~11 or~~Qatbfn -",_ nultlberfor the Oregon U \II Y344" )' ': -. " '-, " . . "flr\_'l::l?? . . :-Expirati<lIl Date I()~ (")./ _ D3 : r,<')pt€200 ainps or'less- ..... .. 201 ampsto 400 ainps -. "-,,,.,:.,:Over401t0600 amps 0,:;,'600' all;p:So'-.~OOO volts see .- "811 above 4...,.,,,,_, , Items Cost SUl11 $106.00 $ 19.00 , '~', $ 50.00 '''F '. sigllatl~d=iciall /0' v OWllers Name 'SLA IS,,'- Addres~ ZS-O. A. Cit). Sf'r(\ --..:.. $50.00 $69.00 $]00.00 /", s+ D. Branch C(~:c.uits. ' . New Alteration or Extension Per Panel N01ICE: ',t ' ~l 'IS PERM\T<si<\~li.ldiKPIRE IF THTE,WS ~~~ $43.00 . j RIZED UNDER THIS PERMI . ~UTHO iY~. 451i.t6JllNOOWiiUoFORh Service '. . l,;OMMENCE,Qr ",ooi'f..!'ernllt. ~$ 3.00 _ ANY 1 BO DAl t:I1IUU'i , ". E. Miscellaneous (Service/feeller not inclulled) -Each installation , Pump 'or irrigation . Sign/Outline Lighting Limited EnergylRes Limited Energy/Con1lll $50.00 $50.00 $25.00 I $45.00 i.f';- Phone OWNER INSTALLATION The iDstallation is !Jeing made on property I O\VIl which is nor intended for s<lle, lease or rent. On'net's Signature: I\'Jinimum Electric Permit Inspection Fec is S45.()f) + Sl.lrchargcs TOTAL Lf-> 3/S :3 1,0 S I 7...L.- 4. SUBTOTAL OF ABOVE 7% State Su~'chargc 80/0 Administrative Fcc