HomeMy WebLinkAboutPermit Electrical 2002-5-29 (2)
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225 FIFTH STREET
SPRINGFIELD, OREGON 9/477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELEC ~AL PERMIT APPLICATION
I>~ City Job Numher O~ .00lo ~, 00'
~ \/~ OtvlPLETE FEE SCHEDULE BELOW
1. LOCATION OF INSTALLATION ' ' u
"3'~ &- C e1J e..V\ Y'\ i' lL-l ~ \ vJ . A. New Residential-Single or
L~~~~~RIP~~~Nrll~ 1 ~~~~\a1QJ
Multi-Family per dwelling unit.
Service Included:
JOJLI~ESCRIPTION
r I \U? 'A-I 'Mi- W\
1000 sq. ft. or less
Each additional 500
sq, ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manufd Home or
of issuance or if work is suspended for , ' " , '. Modular Dwelling
'Ot.. ' . ",/"
180 days, iV...:"::",;':; '. Service or Feeder
, '...'.',', /;~ 1~:'!f..:.'i.,i~..!2..'; ";;G~~ , ~", '
2, C.ONTRACTOR INST~LATIQt!/)fj[r,;'lJ';:;,~; ;'8~~~iS~~;e~;.?l"Ji'~..~ders .
Chrl~tenson Elestrlc. Inc. ~~B-0A;-"""J;+' U~f. JhorIiS1'al!'}f~O.lT"Al~~~atlOns or
Electncal' Contractor J.V'\e~rt;lJ(Lt> AuiV,a~~:?O!,?10 il)f;lterlY~IOii!;'~ :', .
. ;v~b ~ . ((!~~ 8"\~ '"' '-'!ai~ . n!J(V~ -- E;:~;() _ '~~.~ I\.
, '~,v. "-;)' ....''');.:)Q- ; r::'t?'\; t,;,.. t ,.:,.1, 1(.... '0., ~c;. .-ot'"' ..,
Address1298 Bethel Drive "', ... .' ''''', (\!;')y~?O"\1'(ln1'p~''Oi?1;~.s:':.
City Eugene. OR Phone (541) 688~~121" :' ~:~i~;~~~~:$[g ::;:
'60:l'lil,ijipS l~AOOO' amps
, Over 1000 ampS/volts
Reconnect Only
~ u skVVJ
i
Supervisor License N\unber
?71qq
Expiration, Date
Expiration Date
2'00 amps Or less,' , :"
'^.';!"J~\f", ,,20iamps to 400.aUlps
.i',: c':, .)":Y'i'(;';"" Over 401 to 600 amps "
,;:!':~;::} /'~ ':Og~^6,OOamps or 1000 volts see
v,, !(rr~U ('~YBI~:1tbbVe'!' '
,.~\ ._,0:~:i"./,~~~>vj:y t// ,/:/;:v:(?
~''2':~ 10- ".-<~ - /.... "
D. BranthJ~~ 's
~c.~oct..'> New Alteration or Extension Per Panel
''f.... S~ Philips
O~v~ers Name,?pYly\ ~~';eI~i:~f(A011 c,
Address llt/fcy!;,vu.' ifJ~, .~-t.
CitySp \ Y\f'id&Phone 91t'-14 ~ ~ (p '3 7.(
One Circuit
Each AddltlonalCircuit or with Service
or Feeder Permit
OWNER INSTALLATION
The installation is being made on
, property Io\vn which is not intended
for sale, lease or rent:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump 'or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited Energy/Comm
Owners Signature:
;00 .l-;\I; ~)-,-~~t~l~.f
Items Cost
SUI11
$106,00
$ 19.00
$ 50.00
$ 63.00
$ 75;00
$125.00 '
$163.00
$375.00
$ 50.00
$50.00
$69.00
$100.00
$43.00
$ 3.00
$50.00
$50,00
$25.00
$45.00 l1;':oD
.i:~J
Minimum Electric Permit Inspection Fee is S45.00 + Surcharges
L,l. :-'~ Z '-" ([~~I~:~i
JJJ!.:.:
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
4; DI)
31':.
3 ,(pc)
SI.7~