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HomeMy WebLinkAboutPermit Electrical 1996-6-12 T'-\,. fdk~wlng proiect as &u m s t a 0 i." ,n~, 6nd C10ea not require specific land u ,',. ,:i '")v'~'d. '\ 11 Zor"na , J oJ ELECTRICAL PERKIT APP~ON qs 97471 . (\1 726-376~t", (g ['1; cuP Ci ty Job Number V\ AuthOl'l.1.ad Slcnatura *7n/\ -- -r.-U't.)nr ....u:. r r.L ",-"""",JLE BELOV 1. LOCAT~ON OF INSTALLATION .L:..s.~ Ufl1<-Tf+ "ff" ~4!jj)CI-""1 A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 225 r~r.a STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 I ~.oE~ION' r-I'VI -+--J'-)' ~~0.""\ \ n?--.~ } JOB DESCRIPTION ALARM SYSTFM Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for -, 180/'days. "r'" /' /' 2.' CONTRACTOR INSTALLATION ONLY Electrical ContractorADT SECURITY Address_ 1501 Pearl 'iU.e.P>, s"'..tP R CitYEu~ene. 97402 Phone(503)342-1111 Supervisor License Number R-1777TT.F Expiration Date IO-I-On Constr Contr. Number 59944 Expiration Date 4/79 Signature of Supervising Electrician' , ~fL-/ Owners Name Ii7r)/)EK.JJE' 13.e"c.t=..... . ~T1J..1llJJ Address (",.,,~ /.. 1(ltf'1H "A-" S'frt=t-"'C... Ci tY-.Si8 J) c::r 74:72. Phone.S!li- 'J w,. 0/d1 OVNER INSTALLATION 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular 'Dwelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to' 1000 amps' Over 1000 amps/volts Reconnect Only Items 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 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. 'Branch Circuits $ 40.00 $ 55.00 $ 80.00 see "B" above " New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 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 ~ The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: DA~E~-----rti:-r~-~~Zt?- ~~~I?- RECEIPT II: <:::J-.n: ... - RECEIVEDBY:,(._I)~~,}- , - " . , "'\' ", <:,:, -;." 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL ....... . . .~. ,'. . .3tr, DO I.U> ~, o~ "If(, Sly .. ~' ....:.