HomeMy WebLinkAboutPermit Electrical 1998-3-25
~
-
ELECTRICAL PERMIT APPLICATION
- -\~. __~__Sity JWr~\!~'~BKq ~ O..~ 5 (p
NU ( ..... c.\-\~LL E'j..?\R~ N01
\~\S ?aBM\"b"FfPf{'f\Bn~p>~dtlLE BELOV
~OR\1.EO UNO NOONEO fOR
P.U\ A. d!t1'O\Recs~Mitial-Single or
CO~Ml/iE.N ~Ru~~twroily per dwelling unit.
~N',I ..~\'- '~~rVlce Included:
Items Cost Sum
tvt>t Vt-? ~ DcJII)
m I rt:J-iJ
SprllNGFIELO , '
7' , .., I - <. 113 approval;
Yf/ .,Il?fP (?~ - v~...
Zomnp
225 FIFTH STREET
SPRINGFIELD, OREGON ~
INSPECTION REQUEST: A~U~
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
__~ /t!)/:i CC;M M~
/ 1(f~~fj~oDI DO
JOB DESCRIPTION
;Ve-w e~ S~
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Permits are non-transferable and expire
if work is not"~tarted within 180 days
of issuance or if work is suspended for
'180 days.
2. CONTRACTOR INSTALLATION ONLY
$ 85.00
, $ 15.00
$ 40.00
B. Services or Feeders
Installation, Alterations or
Relocation:
Electrical Contractor DJ:..X&U Euu.-
Address 33 /~ b w .MMLrr;.N
Ci tycJ2F.,hfJJI:...R Phone Y;1S-~YO
Supervisor License Number ;SIP/4-.5
200 amps or less ~
201 amps to 400 amps I
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts ,
Reconnec t Only ,
Expiration Date---Jll'-J- ljg
Constr Contr. Number ;:~~I'.fL{
Expiration Date ?- )~-1d
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
00
)cJcJ
&,0 00
3l:?(j ~
C. Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
volts see ~B" above
200 amps or less
201 amps to 400 amps
Si~i5ure of s..upervising Electric,ian Over 401 to 600 amps
~ Over 600 amps or 1000
~w:erlJame~ (UJlJn -- ryl-!{fyfZ"iR.J;)/rw!;anch Circui ts
'l1^ V( '" n New, Alteration or Extension Per Panel
Address--:j' U() _ O~ ^--
vi.' ;.li~ .Phone L1<tY,. 2292-
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
TALLATION
One Ci.rcu it
Each Additional
Circuit or with Service
or Feeder Permit ~
The installation is being made on
property I own which is not intended
for sale, lease or rent.
, E.
Owners Signature:
~~~E~----:rt~-~7t1qr---~~--------------
RECEIPT#"!" 1 - On21-20eJ
RECEIVED BY: V!. 1/1 /17 If ~ ~
~'\..~
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
,
.~
',.
$ 35.00
$
2~.90 lie>
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
{&)'~6
~~~
5'10,00