HomeMy WebLinkAboutPermit Electrical 1999-9-20 (2)
The following project as submitted has the following
zoning. and does not require specific land use
approval.. LOR
97477 Zonmg . q
YJ2t)L3K~ a., @{\-C{5
1000 sq.ft. or less
Each additional 500
sq. ft or ~ortion
thereof
Each.ManUf1d Home. or
I,' -;." ," -. .....
of issuance or if work is suspenq~d_ for .~' . '.,Mod.ular,~Dwe1ling
180 days. :O-'\I~~'t'~\8S a0.pr".::.,'')\~'_ ~~~~.vice.' o~'~"Feeder
, . '\ 1"\' r"',. . t.. ' .. ~ 1 ~ ~ ..
t\. tH;~~t\()f" 18 ' ,....... 0..,. ,110 . ~}\ \..-q ,-,)?,,,\,,,, '..
2. CONTRACTOR INSTALLATIO~~C'~X ~52.rC" o",..II.~. ,;'~IfF~? 9~?1 ~9'r:'" Feeders
In VO') ~~ ':}~2:TI \. . In$tallatt,01il;, Alterations
OO~O 1 ~ .t:'"""' I~\ "'r-. \." \ 11...,-"
Elec trical Contrac tor . _:\'_~ ~ i::l f~2\1:.~~' ,'"O'or, Re~8pa:;~:~n~:
~Gl~'h. . ,,:. o"e;)~rl \.;(,\i~Y I. ..",
flU at' 1o~ th~ ; . ~.~ 2"'-; .~(;.u;.).. $
Address C~-'''ri~:',~~'~''- 00 amps or less 50.00
/ ,.. WI amps to 400 amps $ 60.00
City . . Pho~ NfJJf1Qes to. 600 amps $100.00 _
. ~ ::!~~~~p.s to 1000 amps $130.00
Supervisor Licen7e N m'ber ve'rH!MJl)$Hm1p~Jolts . ". $300.00
~~ &:Qn'J:f'\PIRE 1F'XI:4Ew . $ 40.00
Expiration Date . COMMEN~r:,... IVDER7J;/SPF=DAAn- 'OR#(
/' cAN\'3emI>~~ffiS~'t&<p,~_ "O'rIVIlI'el8llvar
Constr CO~Number r~~~.-Ai~~r-nelocation
EXPirzatien Date 200 amps"or less. $ 40.00
201 amps to 400 amps $55.00
Si~ature of Supervising Electrician Over 401 to 600 amps $ 80.00
~ Over 600 amps or 1000 volts see "B" above
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
AuthOrized Signature
1.
LOCATION OF IN~TALLATION
- 5')1 7 .~t:j, I ~
LEGAL DESCRIPTION
17t, 2 ? 1 ) V' oo/tJ6
u!-
JOIlt gESCRIPTION
/4-dd~ c(/'I-c...lfr
~ermits ar~ non~transferable.and expire
if work is not started within 180 days
,
~LECTRICAL PERMIT APPLICATION
.
~i ty Job Number 99/ / S t
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
Name{'lul!~ ISkt; ~v; D. Branch Circuits , .
A ,
Owners
v / New, Alteration or Extension Per Panel
)2q 3 (lJfiA\. t J/ ~
Address ! Jj-
~f[J/~ ~ One Circuit $ 35.00
7'ft-(j] 7 t
City Phone Each Additional
I Circuit or with Service 1- y
OVNER INSTALLATION or Feeder Permit $ 2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Owners Signature:
1~~~~T7,z:-f}-~4;f~1J-----
DATE: ("1 20 17 -
RECEIPT *: . 0 55C,ri r (71. ~ /' /
. RECEIVED BY:' . . '.A:/ vv ~ .:
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Light~ng
Limited Energy/Res
Limited Energy/Comm
not included)
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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