HomeMy WebLinkAboutPermit Electrical 1998-10-21
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SP.GFIELD
NOTICE: ~,,~ . .
225 FIFTH STREET THIS PE:RMtr s . ~<<!.I . E CTRIC~
SPRINGFIELD, OREGON 97~fljTH()aI2~D HALL SXPIRE 1t=1>--~
INSPECTION REQUEST: 7~<tJ~76?' UNtJ$A TH,.' T.., ,~y Job Number
OFFICE: 726-3759 . MENClilJ On'S PtRMli .
ANy 1M '."J . . n IS ABANB' COM~CW ' EE. SCHEDULE BELOV
1. LOCATION OF INSTALL.ATION 1.11 r PE'M/OO ON~[) FOR
'2)(J:f)r"l C('J(nYr\J}x( J A-I et, . A. New ResidentI -Single or
- /71J2.~II]'~0000 Multi-Family pe dwelling unit.
LEGAL DEsCRlPTtON Service Included:
OrpL\CY\ me H QI1Z/Q .611 1 ~ON:Oregon law requires you to
\) follow rules adopted ~y !he Oregon Utility
, JOB DESCRIPTION 'Notification Center. T~q.u~'lY~.saUodless
~'01n~a.j)ri..D\ 5er '. 9'3~.001-0010Iffl6UgML~~~~~500
,0 OOQO. You may obtain ieS:6f ~ ~g:i!l9n
~ermI ts ~re non-transfer~b17 an(f IT~~fecenter. (~& "EfelePhone
If ~ork IS not ~tarted ~IthIn 1tfd1 theOre~~ il ~~Ma~e or
of Issuance or If work IS suspe'i\'dI~ e fiT t . 1-80 _q' ~_ wellIng
180 days. en ens ~rvIce'r Feeder
f /3 I ~
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Son it ro I Secu'r i ty or Relocation:
City. Euuene
Phone 461-5678
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Address P.O. Box 21009
Supervisor License Number \ld~::rRrr
) p79B-::JLE,evJ
Expiration Date '0 (')\\q::J . .
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number 65149
Expiration Date ..;
6-28-00
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
Signature of Supervis'ng Electrician
~~... ,.
..,
. .
Owners ~ 'C\\'\. ~r' .
Address ~ \:\;.~ ~e.er
Ci ty ~~. . Phone
OVNER INSTALLATION
to D.
l~
Branch Circuits
'.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or .Feeder Permit
.$ 35.00
$ 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 Eneigy/Comm
not included)
Owners Signature:
$ 40.00
$,40.00
$ 20.00
$ 36.00
3n.ll)
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DATE: 10}:;(/r<1 .
RECEIPT #: !) </\>1 '( I I
RECEIVED BY: . # t#"4
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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