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HomeMy WebLinkAboutPermit Electrical 1999-9-13 r - 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 //1 8.> :z:- 1. LOCATION OF INSTALLATION' / ") '7'0 "?/OrJ S of', <<Z- , A. 'Address ;;Z 0'1 J ~ /If orJ Ci ty ~ lA.'1tf",-, t'J,;(.. Phone'll) J' r2 (7~9 . , Supervisor License Number Ib2lAcfiJ Expiration Date /0/01/ 2uz:rD '/ C. Cons t r Con t r. Number ,.)" I!{ The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: RECEIPT II: RECEIVED BY: Q- '~-'19 ~~ ELECTRICAL PERMIT APPLICATION , Ci ty Job Number~ COMPLETE FEE SCHEDULE BELOV 3. New Residential-Single or Multi-Family per dwelling unit. Service Included: 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 I terns Sum LEGAL DESCRIPTION ..il:..t')~. 1...7. ()(J. ~ ' , ,. ,.1 ',re" I/Q..to JOB DESCRIPTION 1-\[ ,.:.1>11',-" d '(\T~" b\,',l()OO,' SQ. ft. or less Srla:::- followfules.a C'.~ ," Each additioriiil 500 "'ot\1lCal"'"'''''''' SQ. ft or",portion Permi t are non-transferable(and~exp'frei1J':r,~,thereof ,L, V if work is not started wi thjl!111180lldays' o\Jta:f';;' Each Ma..n,uf,~ d Home, or of issuance or if work is susp!iiidgdh(f6i)nte'~ ~'. 0 . ,1;I?~1.]~~,rit(R.If,~lling 180 days. number for the; 0.", ,J$erVlC!! or Feeder Cp~,.." ,:'3~' . 2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders 1'1 ("', Installation, Alterations Electrical Contractor $.4 /1'-'" ,{,o'/II ,)17"'5 T,.c.or Relocation: Cost $ 85.00 $ 15.00 ,$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Temporary Services or Feeders Installation, Alteration or Relocation $ 40.00 $ 55.00 $ 80.00 volts see "B" above " Per Panel 35.00 $ 2.00 Expiration Date :J./'l/::Zool 200 amps' 'or less NOTIC~ 201 amps to 400 amps Signatur~e of Supervising Electric~ &;;: Over 401 to 600 amps J L? . ~ ISPl:RMITS/-lover 600 amps or 1000 '_ . r ....1"d~ /.U~ AU:i:JGAIZP" ~LLl:XPIR1=Ir:'7"tJ~' - COMM '-ullJN1}8ffl!nCt'tcunWORK Owners Name U !JS.l. /, l:NCl:DORJ~ /10 SPl:RMIT/SMn-. . IVY 180DAYP ~AA~wn''Ot' Extension Address /940 ~n tSf. ~ Uf> l:RIOD. UR , One Circui t $ Ci ty ~"';^1"....,tt Phone "fCJ- '2.32.0 Each Addi tional ~ Circuit or with Service OVNER INSTALLATION or Feeder Permit E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting--1-- $ 40.00 ~- Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE $40. - 7% State Surcharge ~ ~.~ 3% Administrative Fee -- I.~ TOTAL .:t>~4. ~