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HomeMy WebLinkAboutPermit Electrical 1998-11-2 , AlorlC rHIS ~Date . '-, 225 FIFTH STREET AU PeRMI'" ,~LECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 rHOR A~edSlgnalule J' ' INSPECTION REQUEST: 72613~~,~.s YleD UNDL eXPIRe 'ti ty Job Number q ~ / J. 7 7 OFFICE: 726-3759 AN',' NCeDO eR rJ./tS 1FrHF,.,_ 180 D R IS AJ~ P~~l'LE'WJif\EE SCHEDULE BELOII 1. LOCATWN OF INSTALLATION ;1'( PeRI 8ljNDo ,_I ITISN, /h'1n /!t;UtlCt; I?/ 00, ' A. I1NewFlResPlential-Single or , I Mul d'1Family per dwelling uni t. LEGAL DESCRIPTION Service Included: /I/> 11 \ J I fJ 6 2.() j) Items Cost Sum . yOJl DESCRIPTION ,/ fIrlgf.IV; rWiJ, CIt.tM.'Ii _ ' 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 Electrical Cont~actor ()Js E(c<...!-,,'C... Address 2.1.~l I-t..v","::> Citv Z"'1-"'- YN (.,0;15 3'0/'r) Phone Supervisor License Number Expiration Date /0) 6 } '7 1i3 '2-'1 5" ~~ Constr Contr. Number Expiration Date /1.. - 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular, 'Dwelling Service or Feeder ,B. Services or Feeders Installation, Alterations or Relocation: 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 $ 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' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above Signature of Supervising Electrician ~~ V I I D. Branch Circui ts Owners Name tv! O~/jJ /f/t:f({j/)J) I . / I' ,/ New, Alteration or Extension Per Panel Address /t 'lrJ ~t' it.cO ,e, ((" J~ ~ j1. I ( One Circuit $ 35.00 J Ci ty 'l2tf'k, !-rt;"{L-Phon; 72-'.,3'--" Each Addi tional I Ci rcui t or wi th Service ~- OIINER INSTALLATION or Feeder Permi t f $ 2.00 - The installation is being made onf~~::EN7/~Or~iscellaneous (Service/feeder not included) property I own which is not int~a/~UksadOPt~~stallation for sale, lease or rent. inOAR9/onCente P'~~Ii':f.l:'l!'Q:.g90J9_n $ 0090 Y. 52'001_0;'St>gn{lt~!.tilti'enVti.lhing $ Owners Signa ture: cali. Ou may obI 1.1~jlnbij ~ril!d!&#l( tt#; $ mg the a'Di-nhi. CfMlgg"'; Q6lIitn $ nUmber ~ center (N-"" S Of t.. e'(,OI . Orthe n' oteil/l ',e r'l.l", . ~AT~~--------/77~--fr---------------'-'etJter i;t::>>I[!i!r~~~:~8H~~e RECEIP'fli: .61" Wt<AtI/tJ ]/1~ 3~qfdilll~;;trR'el.lve Fee RECEIVED BY: ,r;J 'TOTAL " 40.00 40.00 20.00 36.00 '3."0'0 J~ ~ /.1 I ~ 5. fG.