HomeMy WebLinkAboutPermit Electrical 1994-3-2
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SPRINGFIELD
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, \\tad ha$ the follow\
. 'Ied as Gubm if lend use
'the io\lowing pro not require spec ,e
. and does
225 FIFTH STREET zoning, \ ELECl'RICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 974"ft,ove, L..A10 ~ 1//1 r-..\ I Lo
INSPEctION REQUEST: 726-3769oni"g~ 'City Job Number '-1.-n J \
OFFIca: 726-3759 . (,".t.~'-:/-~ 3
.. .. \ffi rn\lpu,r. nE SCHEDULE BELOII
1. LQ.!;4T;l:Q!i OF GEN$TAI.I.A;1'l'ONzcd s.,gneture_ ..
~ "-_~':"'l \..)\ l...rf'Ifl\ ~ A. New Residential-Single or
Hulti-Family per dwelling unit.
Service Included:
)1B3~~~ONonl~L:
JqI!..D,ltSCRIl1t.ION Q 0- 1000 sq,ft. or less
\.MDH\l'O ,~J,l.\1)* f\1>_u.~ ..U\.~ ~Each additional 500
~ sq. ft or portion
Permi ts are non-transferable and -expire thereof
if york is not started vithin 180 days Each Hanuf'd Home or
of issuance or if york is suspended for Hodular Dwelling
180 days. Service or Feeder
!
Items
Cost
Sum
$ 85.00
$ 15,00
$ 40.00
,
Electrical Contractor
ROSE CORP
B. Services or Feeders
Installation, Alterations
or Relocation:
2. CONTRACfOR INSTALLATION ONLY
. City
I:'lIr,E]1 I:'
Phone IiRIi-nqn~
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
SJ
Address
89976 DAY LANE
Supervisor License Number -156RS
Expiration Date
10/1/95
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Constr Contr. Number
....
5443 i :'"
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Exptration Date
qnn/q~
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
Signatur~ervising Electrician
. (/~A"//~
Owners Name \\Q ~'ti., \=\.-n * 0 Q \
Address. ~~ ~ S \Jwffl f>
City ~()l_ Phone
OVNER \ IMTALLATION
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addi tional
Circuit or with Service
or Feeder Permi t d $ 2.00 4
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)
-----------n----~------
DATE: t7 ~...<:..,q ~
RECEIPT t: t&t<f (} \. \ '6 t;;../
RECEIVED BY. _ ) -.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
cO
54,
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...c:::,ID.'7.0
Ovners Signature: