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HomeMy WebLinkAboutPermit Electrical 1997-11-7 V 225 mrn ~~ SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 ~"'f THIS PERMIT SHALL EXPIRE IFEIY AL PERMIT ~PPLICATION 97477 AUTHORIZED UNDER THIS PERMIT IS NOT 7 S' Q"_ 726-3769 COMMENCED OR IS ABANDOt-JB1,'C)!f\ob Number q I (..,-- ANY 180 DAY PEf3I9D'COMPLETE FEE SCiIEDULE BELOII 1. LOCATION OF INSTALLATION / Ii) 8 ~ (' 12 L,qnf ~ 47'i'7S--- ItoA26Q 7JNr;2no JOB DES~I6\ + ) pe~~~ :~Lnon_trln~:bl~ na:d :;p:~e if work is not started within 180 days of issuance or if work is suspended for 180 days. A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor~~le~,c- Address 3~!Q~ (q C--e.cb.JL ~, lh Ci t;V/.:e o..so..n-t }I,I/ Phone '1;;J' - bl, 51 Supervisor License Number 34 9,;) 'S Expiration Date /D!, Jqg Items Cas t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: Sum $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 50-DO 200 amps or less I 201 amps to 400 amp~ 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only Constr Contr. Number 84&'7<1 C. Temporary Services or Feeders Installation, Alteration or Relocation Signature of Supervising Electrician ",j~ ~~ -b ~ D Branch Circuits Owners Nallie ;(, ILl< ;::i.'t'em(+~ . Address ID2,;) -(1 Je.e...L. uJ~ lAn.'f' ----I .. .- ._-- C I -1 711/ /i/3' <::: One Cireui t Ci ty Sff.) It'kLPhone - '1. - '1 L) E~~~e~~~i ~~o:~~h Service OIlNER INSTALLATION . . blritlod hoorl.Fe'ede'~ Permi t </ $ The following pro19C\ a:~~ire ~p&CiiiO 1I..nd U~'j I . Th ' t 11 - 'b' 76niMd'nddo5sno r VE II' 11 (' /f d e .1ns a atlon 1S e1nat VU~o,~ on J. J, ' 1see aneous SerV1ee ee er property I own which is W8t int~nd~, ~Eaeh installation for Sale., lease or rent. ~ZOnlng_ Pump or irrigation $ , Dole Sign/Outline Lighting $ Owners signature: 51 netllre-4VV\ T;m'~d Emrrgy/Res $ Aulho g 'Limi ted Energy/Comm $ Expiration Date 7./J'I ! 9~ ~~~~::-:~-7(jt~~~-~~:------------ RECEIVED ny: - 'j; . J1/1 j A _ 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 $ 40.00 $ 55.00 $ 80.00 volts see "n" above New, Alteration or Extension Per Panel 5. SUBTOTAL OF ABOVE 5% State Surcharge 'I'll.....!; 3 rr; 0 $ 35,00 2:00 <6.00 not included) 40.00 40.00 20.00 36,00 ~g, () 0 '1 /1 () I-Ii.{ (p 2-. ((! C/