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HomeMy WebLinkAboutPermit Electrical 1998-6-10 . SP.GFIELD <;C,,;ing. and "does not require specific land us~ c.ppr0val. \. Zoning rl.iI' rdt.,.~1 o-'t.l . .. , 225 FIFTH STREET Authorized Signature l\ ry'\ _. ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477. . NOHv~~ . w()RK qo tV -71 _ INSPECTION REQUEST: 726-3769 S PERMIT SHALL EX~REylr J~ NUiIioer ,() l.flJ lV' OFFICE: 726-3759 THI i"\.co.11:i'~eERMITISNOT .. AUTHORIZf.D U~9JitPLETE' FEE ..s~8ffULE BELOV 1. LOCATION OF INS1;'ALLATION r.EO OR IS ABANDONED . <:;)-~ ~ c:, ~+/....c4 CT COMME!'J~. 1l~~ ~esidential-Single or ANY ~80 DAY ~Q't:'Family per dwelling uni t. J 70~~ODO/ Or Service Included: Items Cost Sum . JOB DESCRIPTION ~ .'J.IAA.T" p~ ,~. . 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 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. $ 15.00 $ 40.00 :. B. Services or Feeders Installation, Alterations Electrical Contractor J<~I~q ~(o~~l~or Relocation: r. . ,.,Je:... Address (? 0 l&"...,e )...~l ~ '1 "' 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only Ci ty, t:~5..p.....JP Phone Supervisor License Number G.~ -b~ 1.1. do - d t?&f t:..- $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 ... , 2. CONTRACTOR INSTALLATION ONLY Expiration Date /o-(-<J>1 c. Temporary Services or Feeders Installation, Alteration or Relocation Constr Contr. Number "lJl?R '7 Expiration Date /'1- ~~o-'ly ~ V'- -AJ-vI 200 amps"oT less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 $ 55.00 $ 80.00 volts see "B" above Signature of Supervising Electrician D. Branch Circuits , ,. OwnersName~....J S"",~--L. Address 5)-- Cf p C.v J-J K;a c.T Ci ty ~'1-h-e" n Phone 1" 1-/77 , OWNER INSTALLATION New, Alteration or Extension Per Panel One Circuit \ Each Additional Circuit or with Service or Feeder Permit $ 35.00 .~~ .DC) $ 2.00 The installation is being made on property I own which is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/outline Lighting Limited Energy/Res Limited Energy/Comm not included) '~ATE~--~-ro-I-It5jf~yr~~------------- RECEI PT #: I Of.... <; uz. '-1 '\ RECEIVED. BY: l/\ - fl1 tf j ""- __ 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ ~S,OD /. IS L/ ' 6_""<::,:) ~7, (7) 40.00 40.00 20.00 36.00 . Owners Signature: ,