HomeMy WebLinkAboutPermit Electrical 2000-5-9
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.
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