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HomeMy WebLinkAboutPermit Electrical 2002-5-2 I. LOCt\T10N OF I.MST ALl,A TION "7 b ~ jd- 'S -r- A. New Residential-Single or Multi-Family per dwelling unit. LEGAL DESCRIPTION . ubmitt~iYilllldiRIlll'di!lP. ---1-70.3 3S'-f z.. 0 '-/. ~l6Dbwmg prole~~~~:quire specific land use zomng, (::IIIU does approval. () Vf\ . JOB DESCRIPTION -La.-' 9 --\" \ v 11100 ''1.tt~. "-." . Iln <={ I zonm ~ .. I vv(,,_t:'" ,u",'--tl"",,,",. \ ~.~_O'2Eachaddltlnn.<OIl . . Date . .fl.i.Q1 ft or portion Permits are non.transrerable and explr~ thorized Signature .....III..VI if work is not started within 180 days U Each Manufd Home or of issuance or if work is suspended for Modular Dwelling 180 days. Service or Feeder . 225 FIITH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 . 'f ~ ELECTRlC"-ERMIT APPLICATION ,: " City Job Number 0 7... 00 230 - 0 I 3. COMPLETE FEE SCHEDULE BELOW I Items Cost Sum $106.00 $ 19.00 $ 50.00 2. CONTRACTOR INST ALLA TION ONLY B. Services or Feeders (' 1 C r::\n -.-.- Installation. Alterations or Electrical Contractor Jj\ ) c::-J<;:rtYlu.J..fC, Relocation: Address 'fl.O. DLX 14~1- . ci09ri~t:~ Phone 14-I-j23lo Supervisor License Number ~ 4S Expiration Date I D \ I \ nl..\- Constr Contr. Number 2fLjLj Expiration Date Cj \ I I 01-- Signature of Supervising Electrician ~: 'CE fJ.QQ Owners Name~Jh.v..,a. / A-t\I tF P~Ic:; D. /11,11 S/- 726 -1(33J Address Zo 0 5. City s//fJ Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: mO:i:l3IH8\7:J :39N\7H:J ~~'9~G $ G:O:J3i:1 lW\7 GOOG GO A\7W:31\70 ~088000-10:#8N\7i:11 200 amps or less $ 63.00 20 I amps to 400 amps $ 75.00 40 I amps to 600 amps (e-"""'< $125(00 ...w ;;0--# . - 60 I amnsto,l OOO,amps\o'"' "" orn...",$t63JOO "',r,....".._ db the ' - Over I\OOO,amp.sl.voltspte Y ul-~ ;,,,$3J5[0.O\"l fo,iu'.''''''-' Th er - - Reconnect..Onlycenter. os r -'J,~Q~~~O!001- r;,otl~R952_001-001?thrO~~~ 01 the rules bY- C. Temponi!Y~l'rvl'O::, '1fl!i~erS\ln cop. the telephone InstallatidR ta\IW.~N!f1JOJER.elooif~~t~tility Notilicatior "'Imberlor the Oreg '\'\1'-2344). 200 amps or Ir:~nteris 1_R(l(l-.. _ $50.00 _ 201 amps to 400 smps $69.00 Over 40 I to 600 amps $100.00 Over 600 amps or 1000 .volts see "B" above Branch ~fri'fc~: HA\.L EXPIRE If 'THE WORK NewJ~~~M.rt~fmli~ ~~RM\1IS NOT AUTHORIZElfUNu nONED fOil{ '1 One rooMMENCED OR IS AB~ $43.00 _ ~NV 180 DAY PERIOD. Each J\ifditional Circuit or with Service or Feeder Permit $3.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighlinq Limited Energy/Res Limited Energy/Comm I A~r, ,I, 1'\;, 5. SUBTOTAL OF ABOVE 7% State Sur~harge 8% Administrative Fee $50,00 $50.00 _$25..l19 ~) .--.- - Lf) '?>J>-~~I'''''''''''.'n. "",' .c".~ ?~ I 1Sl7J I TOTAL