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HomeMy WebLinkAboutPermit Electrical 1999-11-23 fe!!']",' " , 'I J ' .' c... C- ~~~0 :" /r~~"3~ \ 1 "'. 225 FIFTH STREET C2t!~!' . ~' ELECTRICAL PERKIT APPLICATION SPRINGFIELD, OREGON 97477 number!'" (,1 '>' "" ,~:'-ll~" Ci a . INSPECTION REQUEST: 726-3769 Cr .0,,' . ")'City Job Number r (IS 7 7 OFFICE: 726-3759' . ..{. \3 COMPLETE FEE SCHEDULE BELOIl 13lf!f'\~tJ'U~ALrf8cr;~ ~dVl.)A: , '- LEGAL DESCRIPTION r7 tJ '5 35 1 I () 'l..'t66 Ney Residential-Single or Multi-Family per dyelling unit. Service Included: Items 'JOBA~ESCRIPTION 1000'sq.ft. or less n..... lAh v..L.liDmIN. DFvlfl--e. 1.--1'6. "0 ~(}4 Each addi tional 500 ~I",I_ C/JI<tJi1r. sq. ft or portion ~~~~ermits are non-transferable and expfre thereof ~vl if york is not ~tarted ~ithin 180 days Each Manuf'd Home,or of issuance or 1f york 1S suspended for Modular. Dvelling' 180 days. Service or Feeder 2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders L R.;_B bba ' Installation, Alterations , Electrical Contractor NOll~; m, Inc. QIH~tion: 68'W t "Q" St hKCPERMITSHAL.LEXPIREIFl niT Address es rlf",,,,,.. .. ~"'R1iHISPgo,lilTa'D.~S' or less ~Vl;llLC'uL)I_-, '?'Q~pelP.s to 400 amps City Springfield PhoeoM,'.ttt\l~."ffuR'SABANDOV:or am~s to. 600 amps . . ";"'~n.I1V PERIOD. 601 amps to 1000 amps Supervisor License Numbe~Ny1~1 Over 1000 amps/volts 10/01'/)/ Reconnect Only Expiration Date " Constr Contr. Number 08699 Expiration Date 12/18/ CO Signat~e of Supervising Electrician ?;Z~L: / ~,d- - ' / Ovners Name {!LTV OF $//</A!{,F/!db Address c2:? 5 fi rtff :f?fx- ' Ci ty S pf/p . Phone q9f-: {'472 (IIrC 01lNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovner~~ignature: -. ... . ----------r---r,------------------- DATE: illl- U '17 RECEIPT II: '~()7. (..7. tt k RECEIVED BY: J "tJ tWI . Cost Sum $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders, Installation, Alteration or Relocation 200 amps"or less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 voLts see flB" above D. Branch Circuits " Nev, Alteration or Extension Per Panel --- ---1- $ 35.00 35:' One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 5, SUBTOTAL OF ABOVE '1'~ State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00 $ 36.00 35,- d.t.)C; ~,E= . it pDT 1YloNULd. tCA Lonl llT . \ \