HomeMy WebLinkAboutPermit Electrical 1998-9-24
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225 FIFTI! STREET Authorized SIgnature n M ELECTRICAL PERMIT APPLICATION
SPRINGFmLD, OREGON 97477 4'
INSPECTIilN REQUEST: 726-3769 ATiENTtO Ci ty Job Number I Y' /04 r
OFFICE: 726-3759 I fOlloWr I N:Or~on/;;w.__~,
Notificar u es adop/?;fj b ~"'~~S}EE SCHEDULE BELO\I
1. LgCATION OF INSTALLATIOIlJ OAR Ion Center To Y the OregD au to
b~'Ir j..R f'r, <:.-'t' OO.QI) 1,952-o01_001fr~~/~~~eY.,ttliJ}!1-Slngle or
C I' t;umaYobt. r~1l.~tpt-JolJb/<i.r dvelling unit.
LEGA'~ DESCRIPTION a Img the cent am COlS'eSW\1li ~mOfled:
/<60').. 0 J.. 7- ~ 0 ~ 7- 2~mber for the 0 er. (Note: the tIe rUles by It ems
lienter' regOn U~ilit e ~~hone
JOB DESCRIPTION IS 1-800-33 jvr~i{I.Cfltignor less
Eac~dditional 500
. sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dvelling
Service or Feeder
~'
Permits ,.re non~transferable and expire
if vork is not started within 180 days
of issua~ce or if vork is suspended for
180 days,
2. CON'nACTOR INSTALLATI~fiWl:".. B. Services or Feeders
1/~l; Installation, Alterations
Electric,ll Contractor THISPf:~'lrr' or Relocation:
Address ::!THORIZED I~~~~ EXPIRE Jl:Oa,eip.R~. or less
W'VIV/Il1ENCE THIS pr::?.Q'1'';ulllfiS'1!fo 400 amps
City ph6tttl.".... DORIS4B "'PlMTi$1iJfJ to 600 amps
-~ ""1'1' PERIO 'ANDO~fIJIIPs Tto 1000 amps
Supervis,)r Li cense Number D. Over"''lOOO amps/vol ts
Reconnect Only
Expirati')n Date
Cons tr C,)n tr. Number
Expira ti,)n Da te
Signatur,~ of Supervising Electrician.
5Atl w;J
Address b<JL( t .J~)( leA-
Ci ty ~..JJJ Phone
OIINER IJSTALLATION
Ovners N,lme
<; h< I It..
Oil.
7CfLj 7/'-6;
The installation is being made on
property' I ovn which is not intended
for sale, lease or rent.
Ovners S,igna ture:
~ Jr:Jj.
DATE~---'-'fliiiI1'f~-------------------
RECEIPT 11:' I!,/) l...b. I /
RECEIVEC, BY: AY W~
Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less I
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see liB"
[(0
above
Nev, Alteration or E~tension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35:00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40,00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL/OF ABOVE Y'O,dv
5% State Surcharge ~. Ov
3% Administrative Fee I. ~
TOTAL '-( 1 ,...,