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HomeMy WebLinkAboutPermit Electrical 1998-6-22 I SP.lFIELD ". "." approval ZOOlIlp \6.-f" 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 U LJ cunrffl Se.CU.r/ h..l v U ) 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 ~ -;)..0= / ov root .:;21 (Of)