HomeMy WebLinkAboutPermit Electrical 2001-10-24
The!;' . Ing project es submitted hes the following .
225 rlFrH STREET Zdfi,. d does not require specific land uss ELE ICAL PERMIT APPUCATION
SPRINGFIELD. ORE~ 477 r-oIJ
INSPECTION REQUEST: 72',(!11l1q'" 1/\""'1 """ '~b Numbel
OrrICE: 726-.1759 Dal" _ 10 ,c')L-1. ,0 I I'
I. LOCATIO.!::!. OF Ir-fs'I"xt~~f1@ll&ture ~MPLETE FEE SCHEDULE BELOIV
L ,,"-.2- DI1lY\A- <;. ^ New Residential-Single or
Multi-Family per d,,'cIling unit.
LEGAL DESCRIPTION Sm' ice Included:
17 . 03 . 7.:3 . UU' OOI'LO lIems Cosl Sum
.1013 DESCRIPTION I
ytC{)ktco , ~.
Permits arc non-transferable :md c.\:pirc
irwork is not started within ISn days
of isslliJllce or if work is suspended for
ISn days,
Innn sq,n. or less
Each addilional 5nn
sq, n or portion
thereor
Eaeh ManuI'd Home or
Modnlar Dwelling
Service or Fceder
$ln6,nn
$ 19,nn
$ 5n.nn
2. CONTRACTOR INSTALLATION ONLY
B. Services or Feeders
InSlallation. Alterations or
Relocalion:
Electrical Conlmclor0l~b f::U.:{;;:rC:> iG
Address 2..151 VD ()
Cit)~rl oczf' o'JrY Phone')41-14b-4bS f"
Supervisor Lieense Number ..q'E) 1'S S
sf .
2nn amps or less
2n I amps 10 4nn amps
4n I amps 10 6nn amps
6111 mnps 10 IOnn amps
Over IOnn amps/mlts
Rccouncct Only
_$ 6.l.nn A-
$ 75.lIn
$125.nn
$16.1,nn
$.175.nO
$ 5n,nn
bpimlion Date 10- \ - a '+
Constr ConlL Number :<{.5/2Pb
bpiralion Dale 4 - 2.. 0.\-. O"L .. SHALL EXPIRE IF T~6n~2~sKor less
I, . .' I\ UNDER THIS PERfv:iiW?lI~;p,;1jo 4nn "'nps
Signlllure or Supervising E[eclrician 'J OR IS ABAND()NE~'m1"lto 6nn amps
L;l , ~ -' Over 6nn amps or lOon \'olls see
p;.:'/ ,;:' o\Y Pf'RIOD. "13" abo\'e
~~~ -
'l'\ I), Branch Circuils
Owners Name Vh t m A 11'0)(
C. Temporal)' Services or reeders
Inslallalion, Alleration or Relocaliun
$511,1111
$69.lIn
$IOII,nll
Address2...'S-;:l.,? ()()rYV\~
CilyS(JI"I,,,r. Crn:iphone 12.Jo -0140
OWr-'lER ;;st~LLATION
New. Allcralioll or Extension Per Panel
One Circuit
$4.1.1111
Ench Additional Circuit or with Service
or Feeder Permit
$ .1,nll
The installation is being made on
propcr1y I own which is not intended
ror sale. lease or rent
E. Miseellancous (Sen'ice/reeder not included)
-Each inslall"lion
Pul11por irrigation
Sign/Outline Lighling_
Limited Energy/Res
, Limiled Energy/Conlin
$511,1111
$511,110
$25,1111
$45,1111
Owners Signature:
'.
3\:0: iJ3IHS\78
: 39N\7H8
S9'3L $ 3:083iJ 1W\7
100G 30 .l80: 31 \70
9889000-10:#SN\7iJ1
10-.....1.
..
5, SUBTOTAL OF ABOVE
71X. Stale Surcharge
WX. AClil1i'ni;lrativc Fcc
.. .).
TOfI\L
Io~ -
<lAl
<; ,0'-1
c
72....45"