HomeMy WebLinkAboutPermit Electrical 2000-5-23
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The fOllowin' '
zoning: and g project as sUbmitted h '
approval, does not require specj~~ t,he fOllowing
, and Use
Zoning, L'b ~ 0 ELECTRICAL PERMIT APPLICATION
97477 Date - 5 - 2. '3-::-
o _ ~
726-31Ui9orized $,'g ~
naturE'
" -
3. COMPLhll-flEE SCHEDULE BELOY
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION O~INSTALLATION .
<& .3 L J4s C A/J t! [) V tl,t!?..,.
LEGAL DESCRIPTION
AO.B D~}~RI~TJON I . oj 0 f)
-'!:i,t2. ~~fu/ ~/ f:..//P/-
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if ~ork is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Expiration Date
Expiration Date
The installation,is being made on
property I own which is not intended
for sale, lease or rent.
I
Owners Signature:
---------------------------------------
DATE: '
RECEIPT #:
RECEIVED BY:
..c.:i tv Job Number
-
(Ja. 001-50-0/
A. New Residential~Single or
o Multi-Family per dwelifng unit.
Service Included:
1000 sq.ft; or 'less
Each additional 500
sq. ft or portiQn
thereof
Each Manuf'd Home, or
Modular Dwe1l1ng
Service or Feeder
Items
Cost
Sum
B. StJC;~dA~tJdmeAEp,lfs .
~~~~ Instal~atlon AlteratIons
Electrical Contractorks EiM-f~~ ~~~~iIJiQOO~~lN08
/? r;) 0 ION S111,lNtl3d SIHll::I30Nn 03ZItlOHImt
Add ress ~_ 6. _D ~ dl.~9.:l3 }lU9M3HI::l13t1ld~.1~t1~~~kps
Ci ty <J..n, .A:'.L'..k.I~ Phone~""o-/~/t/ 401 amps t!~P.IONPs
~~ 601 amps to 1000 amps
Supervisor License Number 3 Y~7.r Over 1000 amps/volts
Reconnect Only
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary S~rvices or Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation '
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL r
( Tue-..)
Constr Contr'. Number 7C>R-KI
/ ,.2..'h6 /06 .(V17t.G-~OO""amps'.<o'I',-less
I / UU!~t::J'mON ,~~!~Jil'!l.Wafup:S) HH, 4:003raJmps
Signature of Supervising Electrician9uOl..ldelelallO,V,;e.rI\l~0'11l.lt:,o, ~6,00;:Jq!llP;S
~ I J" .\q S810J 94HO sO~e;rJ t6,09.~(amR~ !O.lj, W.....Q,O, volts
._ A c/J..// ~ .. ton-?'G6l::1'ifO u.6nOJLj1 0 \.0(1' ~OO~%(?{"3 ~'r!O
~ v Jot/) ruonas aJ~ Ben~r~ct1l.<;h C:~;r:,r;;,u} r-.$,W:J,HK.
Owners Name _f</ a..~ ( .i.A>/J/la. T 0 ~06aJO ell! i\q pelaClPB'~.elru MOIIC' .
Address 7'~J ('A.:cA/!7~ }~/ue ""'0!:C'1:lH"hrNew, A.J,teratIon .or ExtenSIon
One Circuit --1--
Ci ty S / l.- () Phone 79'/-/ l. Z/ Each Addi tional
l) Circuit or with Service
OVNER INSTALLATION or Feeder Permit --t-- $
$ 40.00
$ 55.00
$ 80.00
see "B"
above
,.
Per Panel
$35.00
3''5
2.00
~
not included)
$ 40.99
$ 40'~o;:f
$ 20.9B~~
$ 36.@,:,,:~
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