HomeMy WebLinkAboutPermit Electrical 1999-4-16
The following project as submitted has the followi
zoning, and does not require specific land use
approval. J "-
Zoning ^-U I?..-
225 FIITH STREET Dete "'/-1/,. - q &f
SPRINGFIELD, OREGON 97477 '. -'-" \
INSPECTION REQUEST: 726_~lZed Signature I\A.(J
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
"~~:r Job Number qq 007</
3. COMPLETE FEE SCHEDULE BELOY
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq. ft. or less /$ 85.00 10
Each additional 500
sq. ft or portion ~$ ~
thereof 15.00
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder .$ 40.00
1. LOCATION OF INSTALLATION
(",92/1 :I U If
IftJ:JtOffl,g () 0
JOB DESQUPTION
.-<; "~'i9-- f-!a VA u.~ J~ul €' JIll",!
Permits are non-transferable and expire
if work is not started within 180 days'
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
<;:;>.l cl t-~CJ-n'c.oJ Installati~, A1~erations
Electrical Contractor l.)(l..\o..I;\.ce " <" I ^\Il'1,.or Relocat~d~/f ~ .
~"1 '> IV.) 4'9 ltoit. ..110"" "'<%J
Address 40& 7 /c..'lda... '('~ 200 amPIQJ'III1)ff.%1&4'I.'ltk/'OOf? $ 50.00
201 a,({ito, ~~'(J'rr/(ISs/o~Olte 'J ~ .~O.OO
Ci ty hU 1-f)/\P Phone --1.1fj) - zSc; 0 401 a~ I,{Qs ,,~c. 1.. '10~'9Q".00
601 alllriffl/lUb ,,~S" 1I ''''IV9 49. XlO
Supervisor License Number 4E5535 Over 10&r~~!"t 1J&~Y/n;:;904'; ~Bt~
~ Reconnec t' ~ 9Y/;(, 0,,-<. '(}.., ~ :4!I.fJ>>;;l7v
Expiration Date I / "41FJ; 9tJsl '~/v. Oa.",$. 0-1' a
. C. Temporary ServiceS/~~~~ 6ltt;" 600
Constr Contr. Number ?.t) -<l31C Installation, Alterat'nll1. ~~/~~Qw,'on
, 01.1. "410' ,~o/i'-
Expiration Date /0); /qC; 200 amps"oT less ""~{A6',OO
201 amps to 400 amps $~~.OO
Over 401 to 600 amps $ 80.00
~' Ov r 600 amps or 1000 volts see "B" above
B Ohh' .'
. ranch tlrcults
Signature of Supervising Electrician
~J~~aA.d- (p,tiYPfllJA:
0, N" ~ r'\r..\ 1.1
wners ame,~. _.. -.,:. -" .' '. ,~l:r_
Address~(O II I/o VCL~ f r;
Ci t~fY ~& -f J'd Phone / lit! /1 K 71
~STALLATION ~~
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
, r
~~~~:~-:~~17~-~~;:!~-----------
RECEIVED BY: ~. VlL1",
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation.
Pump or' irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One \Circui t
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
I Ie:, 60
c....._ 1'-.
"2'. rj ".
/ /Q-LT,).