HomeMy WebLinkAboutPermit Electrical 1999-9-15
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225 FIFTlI STREET ELECTRICAL PERHIT APPUCATION
SPRINGFIELD, OREGON 97477 Ciu OtJ
INSPECTION ~aUF.ST: 726-3769 City Job Number 71 I!> ~I
OFFICE: 726-3759
1. ~l'IlO OF re~ION
.....rl->'" \1\.)1 l-:rJ
LEGAL. DESCRIPTION. \.it' Y
k\ I~I'-. v'l.:1h;l;7w~l9r8r~iiI';'''h
fo\toW fU'''''.... ",,-' 1 hOC'" rUlef i11r; ";'-" - 1
Notificetior. ceJOn, .DE~C" .~ION,A 952-0(J -
. Qrv,l,)" ' ,- -,=-J~,,,,-,.,,,
in OAR 952-.J f-f!!' f . _ :.nC ~.IV~
OORO you may UlJ'~'" --'"'I\1et3Ieprol~iV
. ilin(,P.~.x:.mi,t:;',E'ar'E!'l'i\?~:;,~6~!'8\;~!.1lble and expire
ca "f~),:',9.~k:ji(sJ~'o~JI~,t~r.tc~. ~i thin 1.80 dilYS
numbeof issuance' or~,f vork is suspended for
...... . .,
180 days.
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2. CONTRACTOR INSTALLATION ONLY
Add,ess '(? -'
Ci ty 3iAo.Uw...- PhoneJO~ R---IdJ/
supe~ense Number d, 1.'0-, ~
Expira~ion Date~l }qq
Constr Contr. N::;::raO-/7C?~ C.
Expiration Date 10/DI/c;Q
. I I
Signa~_Of~iSin& Electrician ,
'---V. .^-.IA-'1T/iIf(IJ PII/LJOC;-
O\lncr~ Name Y+//aUA-1 D_
Address t: d, 8lJ~ II $ 2- 8
City EFU~(i}Vt:i PhoM tf1'1Yu
OWNER INSTALLAT~ON
The inst.:lll<ltion is being made on
prop~Lty I QVn yhich is not intended
for sale, lease or rent.
Owners Signature:
~~~-~~J-S::-~-------------------
RECEIn ,: / 15~&.rJ"
RECEIVED 8 Y :1::J..Jn.a Ih tLd,A:)
3 _ COMPI.ETE t'EE SCHEDULE 8ELOV
A. Ne~ Residential-Single o.
Hulti-Family per dvelling unit.
seNtff,e:1:~uded: ~1"~\F1'l-lSWORK Sum
;&1-115 PERMIT 51-1/1.LL E 11-115 PE~ti! 15 NOT
~~~~m~l~~~BANDONEDF"8g -
sq C<3IlJ\MiN{i'4iU l-8n
there$~MnAYPERIOD~ $ 15.00
EacIANan\l't"'(I'llome. or
Hodula,'Ovelling
Se.vice or Feeder S 40.00
B. Services or Feeders
Installation, Alterations
t" Relocation:
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 -----
S 50,00
$ 60.00
5100.00
$130,00
5300.00
$ 40.00
Temporary Services or Feeders
Instal.lation. Alteration or Relocation
200 amps"oT less
201 amps to 400 amps -----
Over 401 to 600 amps -----
Over 600 amps or 1000-vorts
$ 40.00
S 55.00
S 80.00
see na"
above
Sranch Circuits
"
Nev, Alteration or Extension Pcr ,Panel
One Circuit
Each Additional
Circuit or vith Service
Or Feeder Permit
5 35.00
S- T. 00
E.
Misccllaneous (Service/tecder
-Each installation
?u~p or irrigation
Sign/Outline Lighting-
Limited Energy/Res
Limited Energy/Comm
not included)
S /,0.00
S 40.00
S 20.00
/' S 36.00 ~
3(.",uv
';;>","50"-
/-~
,;<. q., (.-?c,J
5_ . S\JllTOTAL OF ABOV];
~ State Surcharge
3% Admini~trative Fee
TOTAL