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HomeMy WebLinkAboutPermit Electrical 2002-2-22 225 FIFTH STREET SPRlNGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 . ~~towWI\!r# tll\'2-~~21.f' 01 ELECTRlC.ERMIT APPLICA nON 3. COMPLETEF:~YS::E::::E:::OOI 9V_O~1 , A, New Residential-Single or Mnlti-Family per dwelling unit. LEGAL DESCRIPTION I Service Included: 170.z 3Sz.3. Dt:::>31m~npproiectass b . Items Cost Sum U "'J", ano aoe~ nOl re u mltted has the fOllowing a,..,~f(;V81 qwre; SpecifIC land.. 1000 sq.lt~fl't less ZOOlng _ !..pt't Each additional 500 VAte "2 - 2- 'Z-o 2 sq. It or po.ciulT Permits are non-transferable and,eJ(Wr.~.u ,,",' , ,.(. '\ uren:of if work is not started within 180 days YIoUlur. VIJ". Manufd Home or of issuance or if work is suspended for Modular Dwe 109 180 days. Service or Feeder I. LOCATION OF INSTALLATION q{,b LAk~~VlU\ I J')~(' JOB DESCRIPTION BL>W",j' Mo",W\ $106.00 $ 19.00 $ 50.00 2. CONTRACTOR_INST ALLA nON, ONL Y_ Electrical Contractor -AJ:lT" StLlJ'( ; ty' Address 2.ilS Sw IS3t! Dr. City_ Bo!lAlI~doV\ Phone5,j~~II(,1711'O _ B. Services or_Feeders Installation, Alterations or Relocation: /i -- , . ,'" hl," .J.lf. q~q,..M6SyoutO ".~ i ::";'~_,ll?'a~s-2.ness ioi Oregon Utilii\!-- $ 63.00_ Ivl,e:' ,UZOl ~W>C48~ :\",'IiFes are set fC'.!1h- $ 75.00 _ i':0tifieatir40~11lnP'itJ/;,&~cm OAR 952-0'" - $125.00 _ InOARg=60jlQrt;~1b?IIi!f6'\illlps h le3-"'1 $163.00_ J090. YDlOver.i10'O{jf8\B~{tfllR~ all e ru ,,- $375.00 ca\lingR!eeo:iiii.ecjlOIJ~'Jte: lhetele.~ho~- $ 50.00- 'lumber lor the Oregon Utility Notllicall,7" - OHnl1ijidr8';fs~Nr.?eltPFeeders Installation, Alteration or Relocation Supervisor License Nrunber 7R3 i Ie ~ Expiration Date 10 -01- 0 Z- Conslc Conic. Nrunber 5"44 Expiration Date S. 7 - 05 Phone~I'7U.'t"' 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts see NCJTfE'E: THffi flH1JIIl!lIrS'~A\!.LI€XPIRElFlHEWOAJ( ~~5'tl~b~m~ERIVlmSNOT CQM~liDOR ISABANDONEDFQR$43.00 ANY 180 DAY PERIOD. Each Additional Circuit or with Service or Feeder Permit $50.00 $69.00 $100.00 . '<!"\If/""' Signature of Supervlsl ~~/~ ----- >- \J '-........ 0<J Address L/hb City sPrn OwnersName~VltlLJ BLlil~rd. L'A-t$MbV Lt" OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. $ 3.00 Owner~Signature: E, Miscellaneous (Service/feeder not included) .Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm $50.00 $50.00 ~ $25.00...Z:.5.. _$45.00_ T90:::J3IHSti::J : 39NtiH::J gL' TIj $ G: G::J3::J _lWti GOOG GZ 83.:l: 31tiG vOTBOOO-TO:#SNti::Jl Minimum Electric Permit Inspection Fe~5,oil.ct:.-> Surcharges TOTAL 45.00 ~ ~ ,. -- 4, SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee