HomeMy WebLinkAboutPermit Electrical 1998-12-14
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225 FIFTH STREET A~~SBl\I:~, ELECl'RICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 117~ct, lawre .
INSPECIION REQUEST: 726-~. ~9S2_0Q~nter. Ih y 111eo~ob Number q 1(' IS" 27-
OFFICE: 726-3759 _ Call.' Ou tnay -0010 thOSe rul, reYon fJ. . ,to '.
nu tny the Obtai ~toudiP~~ ~ SCHEDULE BELOW'
1. LOCATION OF INSTALLATIo3'berfOrt%enter. ~nCOPies ~A9S. tfOrth
/6 go- I C (!) new /VO()O Celli>:: ~ OreYON9I.e: tl:~~h8~ai({.>~.tial-Single or
, ,-I IS 1.800 n I.Jtilit;}~~~#Jht/!:fnbj:y per dwelling uni t.
LEGAL DESCJ.UPTIQp 0 ..... (;If) '" . .332_i~~kan.n~ncluded:' "
L:7 o.~W6~- :::::> L ~ ''44). IOn Items Cost
;100 "* 42...j'4-
JOB DESCRIPTION
(noue SeRVIce- /J1,4t;7
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
:..
SPRINGFIELD
,
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular. 'Dwelling'
Service or Feeder
$ 85.00
.
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
2_ CONTRACTOR INSTALLATION ONLY .B.
Electrical Contractor L.JI. J/M./!IS ~
. ~ IVan .
Address.1i.j SH~ ~1i;(".:: 7C~.:' 200 amps or less I $ 50.00 GO =-
I '~p~~' 201 amps to 400 amps --;-- $ 60.00
Ci ty "PEP Phone 7}fpf/../i5?YJ'(I(r'~/i,A 401 amp's to. 600 amps $100.00
. Q)M ~r,I<S.') "ll ~..\J601 amps to 1000 amps $130.00
Supervisor License Number '1.6,~1-",.....,;> (jND~R 70~~F,.::-1000 amps/volts $300.00
, ' 1~fJ FJ;,....u OR I. rIiI.BpCO~€.t, Only $ 40.00
Exp i ra t i on Da t e ~ - I - 7. t>v ( ,,:y PI:;" S 48 u ~11A1, WOR/(
-'4IVD. c~N~mp.o~~V~ervices or Feeders .
Constr Contr. Number C) J B':;<6" InS:-Pa~tilln, Alteration or Relocation
Expiration Date 7 - ~ -1' ( 200 amps' A()'t' less $ 40.00 1
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Si~~~f SU&21,'sing Electrician
~~~,
,f 1/ I'
O....ners Na~ f'A.i~d" L : ~1f"lf
Address I ~~/ 4(Tb'lVt./b1l/f?
City $ffj) , Phone ,4l-"f~O
D.
OVNER INSTALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Ovner~~~gnature:
.
. . - .
DATE: /'~/Nlq r
RECEIPT 1:: () 52 S' () 2-
/; (JJ~/.
......
---- ---.-
Branch Circuits
,
.
,
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or' Feeder Permit
$ 35.00
.
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
...nor ^ T
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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