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HomeMy WebLinkAboutPermit Electrical 1996-2-28 . . " '" d.. doct . oubmltlod ha!l th9' <.:>-ATE W A-'-I L.' 1I1Nt,.. 'l1',!I!if.,(;N\.,g pr . 01 ~~'uir. opoClfiC land \ - \ zoninn. cnd does n ......, . . 225 ,FIFTH STREET approval. n ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477, .~Dj~ INSPECTION REQUEST: 726-3769 ~ CV;; - Ci ty Job Number .q -s/~ 'Y:> OFFICE: 726-3759 D,:. C>" . '[,.... n . \ ' ~LETE..E.EE-SCBEDULE BELOIl I.' LOCATION OF INSTALLATION AulhoriZodSlgnatunr \ ' b2..o- 'CIa/WIt L~ J.,p A. Ne.. Residential-Single or " Multi~Family per dvelling unit. , LEGAL DESCRIPTION Service Included: r?-z:>~-2'2_'-i"2 _ ~~V' " JOB DESCRIPTION \A/1ft/:; ~~ .Ho.......E .. . ','. ~) Permits are non-transferable and exptre if \lork is not started" \lithiri 180 days . .of issuance or if \lork is suspended for '180 days. ' 2. CONTRACTOR INSTALLATION ONLY Electrical ContraCtor l.-rlr MO/!It/5 I!f.l":t::r Address.rf<<~ SH~LL~ ST~ City SPt:-o. Phone~/-~" . Supervisor Licen.se Number 3e>vc.. - c;. Expiration Date /0, /- '1 Y Constr ContI'. Number Ol"~cr Expi'ration Da~e(, "C', p, fb Signature of SupervIsing Eiectrician "~ -' ""Q.e..---- a,me 4$5-~~~.N", Address /,-/ij7~~./'f'~* .&. , City tFfi..r:.:<~e:!' 'Phone=3'cr5'-~ 'OIlNER ~STAirhf'&:~ . ' ...:,.... It~ms 1000 sq.ft. or less Each additional 500 sq, ft or portion thereof, , )1 f,., Each Manuft'd Home or Modular Dvelling Service or Feeder B. Services or Feeders Installation,' Alterations or Relocation: Cost Sum 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 L ~S~ $ 85.00 $ 15.00 HE.. $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40-.00 c. Temporary Services'or'Feeders Installation, Alteration or Relocation Ne.., Alt'era tion o'r" Extension Per Panel . .' -. 'O~e Ci rc'ui't' .Each Additional' , , Circui,f'or ",fth Ser.vice, , or' Feeder, 'Pe.rmi.t ' -..'" . $ 35.00 $ 2.00 not included) E. ,Miscellaneous (Service/feeder -Each installation j?uinp or, fi.-riga tioh' Slgn/Outlihe Lighting' 'LAinit~d,EnefiYYRes Linii t.ed.~n.~,r~/ComlTl 200 amps or less ~ 40.00 201 amps tQ .~OO amps $ 55.00 Over 401 to 600 amps $,80.00 Over 600 amp~.or 1000,volts"see "B" above D.. Branch ciicuits :rhe, installation is,: being made on property,~ o..n,vhi~h, is not intended for sa-l.e, 'lease or ~en.t. ,(}vn,ers Signa tur.e: . ~ : . '," .. '.' .... .. .' :..... ..' DATE: ':2 _2. K".~' RECEIPT. ~:. .,'2~~,=?~.;. RECEIvED' B'y:~ ..."..'~ ~ 5.. SlmTOTAr. OF."ABOVE 5%'State,Surcharge , ,TOTfU. ' .' " '. ~'. . '. . -:..; t', ,", + 3DIo ' M",'\(\ '~~ < $40.00 $ 40.00 $ ,~o.OO $ .'36;60 , ').'Cl;; ,,~ 10 2.$' <.. /!> ' 2z,1 4-~ -