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HomeMy WebLinkAboutPermit Electrical 1999-1-5 ):. ,,~ zoning, and does not require specific land use approval, 225 FIFTH STREET ,Zoning ~DR. SPRINGFIELD, OREGON 97i(jiAe, 1 - '5 -~'11 INSPECTION REQUEST: 72Jh?c769 , OFFICE: 726-3759 ut onzed Signature 1. LOCATION OF INSTAL~TION ,f C:/,1J (' A {(iAfJ 7- <./ LEG1*t~:rB~~D(cJ{pO Y ~OB DESCRIPTION 1/9 /Jit1 ~fJ.. :2 ;,'f1!a',' /1 F Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for- 180 days. 2. CONTRACTOR INSTALLATION ONLY B. Electrical Contractor () 9./1 ~ f heJl,({!,. Address .to) ,/j'l d ~ I7tJ '7 Ci ty >A.1. ~ f:h 7 Phone (, Y ~ - ::>-5 () 9 Supervisor License Number Le '7f?' - S- f (J - L - ,).6 () ,1 '1 rz 0 D 1--19-lctq~ Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician fJ/~ K~~ . __ D. Owners Name (\lY-P-i.'5-rODhkv? e/A~fw1Dnl S'~O Ck5CA~f_ City 5flPJVlcel~cztJphone 7)& "'&7l3 't. OVNER INSTALLATION Address The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -------------f--J-----------------~---- DATE: II ~ C(q_ J ( , RECEIPT #: 'I \ Jl<1-Lf)() RECEIVED BY: ~ :- t-v).( /1_ .=-- "'T.~CTRICAL PERMIT APPLICATION City Job Number qr I S_~V 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum ,1000 sq.ft. or less $ 85.00 Each additional 500 s.~U-TH\n~bf~.oJ: t i on 1!Mo;w(jlJ/e . Oregon law ~~. , $ 15.00 ~P1ti!tillc~~Pd1~b9 Fhe "'iU" tI$ you to InMM.R~~_ ~~t~iIDlJose rU/OreQ.on UtM'm'/it .. Ocsm;~LLce 1-~@i!dll4r- es are s$t 00 .ruu may . l1Troug~ calling tge@ Obtam Copies of th 952-001_ ~~nt11i~ !@n~~6re' tho ._i_e rUles by Insta g.rtt~r~HUar':fOllt1lrePhone, or Re ~~l1iQll~800_3 IMy Notification 32-2344). 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps ,to 1000 amps $130.00 . Over 1000 amps/volts $300.00 Reconnect Only $ 40.00 C. Temq~fl~~~ervices or Feeders Inst~Il~tion, Alteration or Relocation THIS PERMiT SHALL EXPIRE IF THE WORK 200 A<L~PrfO~~E+f=i~~DER THIS ~ERMSr ,'t-O~,QQ. 201 amps to 4-00 amps i $1 S:S. 'EJe> OveJ8CL{0!J!1Eto~r():<[)O\Farfi!prs3ANDONE[$Ft8Q. 00 . Ove7;j\,6p93\r-BR~' [.q:Rlt:R.90 volts see "B" above Branch Circuits New) Alteration or Ex~ension Per Panel .- - One Circuit $ 35.00 ,~ S Each Additional . Circui t or wi th Service I - or Feeder Permit $ 2..00 2 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ J ~'9~~ 5 i '1-~ ' q. 40.00 40.00 20.00 36.00