HomeMy WebLinkAboutPermit Electrical 1998-6-22
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SP.lFIELD ". "."
approval
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DdtaCo-Od-.-C\'f." ELECTRICAL PERMIT APPLICATION
~7.#1,{Z<ld S1anatura ~ ~ rA 0 D 1 } J-.-
72'~-3/6<r NOT\(,t:.. cIty Job..~ber -/ ^ I,,) I
CJ-lALL EXPIRE IF THE WU
THIS PERMIT '3 ' -cO;'R{S'Plfum:IS'!il@IfDULE BELO\l
1. LOCATION OF INSTALLl\TION AUTHORIZED UNDER ("\Q.
d 5? -4 q--'c""wea u. _.P./ ' ItJR I~T\S~ fHtl-Slngle or
vUI'IIl~CED J:\ul tl-Famlly per dwellIng unl t
u;,G1o~tllf~IO) _03C/O<8lY180DAYPERI@I?rVlce Included Items
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST-
OFFICE 726-3759
JOB DESCRIPTION
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PermIts are non-transferable and expIre
If work IS not started wIthIn 180 days
of Issuance or If work IS suspended for
180 days
1000 sq ft or less
Each addItIonal 500
sq ft or portIon
thereof
Each Manuf'd Home or
Modular DwellIng
ServIce or Feeder
2. CONTRACTOR INSTALLATION ONLY B. ServIces or Feeders
InstallatIon, AlteratIons
Electncal Contractor SOrlltrol Security or Relocatlon
Address POBox 21009
CIty Euuene Phone 461-5678
SupelVlsor LIcense Number 110159 t2E. T
Expna non Date 1 () - / - 9 Cj
Cost
Sum
$ 85 00
$ 15 00
$ 40 00
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch CIrcuIts
Constr Contr Number 65149
C Temporary ServIces or Feeders
InstallatIon, AlteratIon or RelocatIon
Eypna non Date
6-28-00
SIgnature of SupervIsIng ElectrIcIan
~~~~,,-
Owners Name L1nn Sc.hachner
"Address ,.;;J>?4CJ Chafea If PL
,. .
CI ty <,Sfl'r1Sh f'. /d Phone 74/J-IJ//5
O\INER INSTALLATION
The InstallatIon IS beIng made on
property I own WhICh IS not Intended
fOl sale. lease or [en t
01mers SIgnature
~AiE----701~2:1~~-----------------~
RECEIPT 11 I ( j<OlJ ( I - '
RECEIVED BY: I-{;. Vh"~
$ 40 00
$ 55 00
$ 80 00
see "B" above
New, AlteratIon or ExtensIon Per Panel
One CncuI t
Each AddItIonal
CIrcuIt or WIth ServIce
or Feeder PermIt '
E.
MIscellaneous (ServIce/feeder
-Each InstallatIon
Pump or IrrIgatIon
SIgn/OutlIne LIghtIng
LImIted Enelgy/Res ~
LImIted Energy/Comm
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% AdmInIstratIve Fee
TOTAL
$ 35 00
$ 2 00
not Included)
$ 40 00
$ 40 00
S 20 00
$ 36 00
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