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HomeMy WebLinkAboutPermit Electrical 2000-5-9 t . SP.:FIELD The following project es submitted hes the following zOning, and does not require specific land use 8lJproval. Zoning r1.'!../ 2.2.5 FIFTH STREET Date ,"$ ~'1 ~ 0'\) \ SPRINGFIELD, OREGON 97477 ~ INSPECTION REQUEST: 72.1>~~I'1~O Signalure OFFICE: 72.6-3759 7 o AMlRECD:2 $ 39.60 . CHANGE: CASHIER: 059 ELECTRICAL PERMIT APPLICATION I\.....LJ~SCRIPTION '.--r- /I L 1000 sq. f,t. or less cJliiJ DA - ( !1-14 1'..-7\ IW1 I . nu L'.LJ ~ ULfJ~ Each add i'Vonal . 500 sq. f~o'or portlon P .. f bl d' h""" f _'0 erml ts are non-trans er~ 7 an expne , \:~. erE!o,' '"",A' if ..ark is not started "lthw 180 days; eotl'Each\'Manuf'o"Home, or t'\~ oc:.... . lr. .11' of issuance or if ..ark is suspend;p f~~ooY, \~O'~~j~~~~~D..e*fing l80 days. . ',.rl\v\e-Cl''\'''' ,,\,'~S'er\\(lce\~oriFe~der \0\\0 ~,o": l\" ,0\ 1\' CO"", W' 'o\\\,cv 2.. CONTRACTOR INSTALLATION ONLy,,\'C~~<{t.\\'B'P':,ser~ic'iis' ~r Feeders '()~ -(O\\(\\?C,e\'~ Ingi:'ailation, Alterations Electrical Contractor L",Hl-/;/ ~},~';"4 A,eOo-r Relocation: C,",,'" e\\u. ..; . Address }900 ~~ _~ ~~~C'; 200 amps or less o .' 201 amps to 400 amps Ci ty r .u~/ /Y'\O Phone - 7 40l amp.s to 600 amp's o . 60l amps to 1000,amps Supervisor License Number J J I 72 >' I Over 1000 ajl!PsY~o~,~,s ! . - Reco,:,&?~e<bnlitJ~?>~ ,,\1 Expiration Date /0 ~() I - ~oo;;J, \y;O(J? c1\y;OY\1' \ n / C. TemlW~'i'y ~e.f9fc~~cpr\'Feeders Constr Contr. Numb'er '1{)LI? ~~Pta~16~t10nS~'l~t~r~t9P or Relocation Expiration Date L\ .:.. \ q -'0 d- 'dO~~~~a8S~pq.~~~leS;'~':) $ 40.00 . O~S\ ~~~amps to 400 amps $ 55.00 Electrician ~"''dOI'l'~ Over 40l to 600 amps $ 80.00 l' . Over 600 amps or 1000 vol ts see "B" above ~y Job Number 3. COMPLETE FEE SCHEDULE BELOII 1. LOCATI.9!I OF INSTALLATION fJ~~ Y La /,LAC\.. LEGAL DESCRIPTION i~O~:,1.,~ 10 ~~ A. New Residential-Single or Multi-Family per dwelling Service Included: Od/I g- It ems Signa u (~:;~r~is~ ame \ [;j.1 Address ~('J ';1'4 J.CLLUJ a.. 3J CitY~>J1cdilihOne 7'-1",- /1/0 O\INER INST~N D. Branch Circuits Cost Sum $ 85.00 $ l5.00 ,$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 " New, Alteration or Extension Per Panel 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 7% State Surcharge 3% Administrative Fee TOTAL One Circuit Each Additional Circuit or ..ith Service or Feeder Permit The installation is being made on property I o..n which is not intended for sale, lease or rent. Ovners Signature: --------------------------------------- _ &::) - 'X-CO io /-;;l.. " , ... DATE: RECEIPT #: RECEIVED BY: $ 35.00 $ 2.00