HomeMy WebLinkAboutPermit Electrical 2000-8-9
7
DATE:AUG 09 2000
AMT RECD:2 $ 42.90
CHANGE:
CASHIER: 059
ELECTRICAL PERMIT APPLICATION
City Job Number riD-O \ letS - CJ }
3. COMPLETE FEE SCHEDULE BELOII
. . 5 submitted has the to 1(\ , l~
The tollowlng prOlect ~ quire specific lam;, ....')t'
lonmg. and does no ra .
"~~, oval. f) rL-
. . 1_
ZonlOg -
$?'<=i-~'
225 FIFTH STREET Date - =- \ .'""
SPRINGFIELD, OREGON 92iblzeo Signature ~
INSPECTION REQUEST: Ilb-3769
OFFICE: 726-3759
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
NOT/Cr:. '
B. Servi'ces or Feede~
rHISf\1S;i,al':ra,t-dionc,XAlter,a t ions
Electrical Contractor /....; rh ~ AunomRelocatto'nr'Hl:II- rHEWORK
_ ' '::. :<.~~ ul~Dt:R THIS PERMIT IS NO r
Address p'O. ~o;r I J /:Pc, , COMr200CampSRo~A!;~,~IDOI~EC~__ $ 50.00
/. r...? _ C.L::,d:,AbNY1ZQ!:>JW1\Pf!R,t?0400 amps' v", $ 60.00
Ci ty (;f/..; b . Phone COo 5 <r /-, 401 amps t'o 600 amps $100.00
601 amps to" 1000 amps----- $130.00
Supervisor License Number ~ C ":;3>5 Over 1000 amps/volts $300.00
I Reconnect Only $ 40.00
Expiration Date 10 7~(jb
. , C. Temporary Services or-Feeders
Constr Contr.' Number ~C;Cj 7'fX "..'" Installation, Alteration or Relocation
. .....-'....~..... :.:.", 'c
Expiration Date < J'Z-t>oZ- ~:;;:~~~~'lPO>9.tl~.t~Oi~;@n'liiil;t,
,( OAR 952-o~~~fulam s~ t<>Ie400eampSJr,
Signature o~uperViSing Electricianl)90 You.ma9xer ~4" ijOvt;li'~e91 ~llf)'
;.,/. ~ calling In'; 'Ov~'fl 6eGDramp~ t'&rril~O.)volts
<-() c centel (Note'!tIe t 'I"
- q '.....her '0' tt).o () . '.. e ~~tlon€
, U ,~;..~~tll:~~~~tilttYM:sificatit>r
Owners Name lil--:JJ OI1-c,ej74-S ")"'" ,"C,.~"",,:,"
1.
LOCATION OF INSTALLATION
7 ~ t; C; (Jt.~1M6N7W lK-1
, A.
, ,
LEGAL DESCRIPTION
1..0 "" ~ Lit""
, JOB DESCRIPT~ON
I~ PI/x-. Pv/UV~
Permits are non-t ansferable and expire
if work is not started ,within 180 days
of issuance or if work is suspended for
180 days.
r.r:;'-/GO
2.
CONTRACTOR INSTALLATION ONLY
.
,... .
Address 7? \
City ~ tYp.
/::::7Jc:"~t7;VTt</ IrvJ
Phone 1'U-7761/
- ,
O\INER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
~
DATE~------~T~:T~~---------------------
RECEIPT II: ~9-:j-:r-
RECEIVED BY: ,,J D
New Residential-Single or
Multi-Family per dwelling
Service Included:
unit.
Items
Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 40.00
$ 55.00
$ 80,00
see "B" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permi t 1"
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
(
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
3q,~
Q. :~. 3.
/-i.lX6