HomeMy WebLinkAboutPermit Electrical 1994-4-8
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The following project ." submittAd hoo the follow ng
zoning, and does not (t'~quire specific land use
approvel.
225 FIFTH STREET , L'" /)
SPRINGFIELD, OREGON 97477 Zomnn 'LX--
INSPECTION REQUEST: 7e~3769 t!-'{ "CUI
OFFICE: 726-3759 '. \ ~
Authorized Signature t-J._
ELECTRICAL PERMIT AP)1ICATION
City Job Number Y4n4(&\
;;Mo~ ......... 'nE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
JI<;,n 'il\\\rU\ I ~,; .J.fn~a I ~ A.
-L~~ryrFTIONrr14C{)
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.JOB DESCRIPTION
-Lili.:1Jl .. 'n 0 (\-f, r \I;mwarJe 11 ~Q, .
Permits are non-traftsferable and expire
if york is not started within 180 days
of issuance or if work is suspended for
180 days."
2. CONTRACTOR INSTALLATION ONLY B.
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Electrical Contractor...u.~ @~o(ll rtl [I \I~'
Address P.O. 'furrJ. It/. 21->
Ci t~r\.l m ~.\..ll1L Phone ~11,.3 b
. Supervisor L~~en.se Number I to 2. h c')
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
10 - 1- '\5
(')?l <;( tl-q
q - I - q~
EKpiration Date
Temporary Services or'Feeders
Installation, Alteration or Relocation
C.
Constr Contr. Number
$ 40.00
$ 55.00
$ 80.00
see "Bft
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Expiration Date
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Signature of Supervising Electrician
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r OvnersName PC1(. Rn~~,
Address..J...L5LL:n'Lrt.flUm ,Jp3
Cit~rr\.;('(\').~o~rL.Phone '14'1- J.,Li-51
OVNER INS(,j,.ALLATION
above
volts
D.' Branch Circuits
Nev, Alteration or EKtension Per Panel
$ 35.00 35,00
One Circuit
Each Additional
Circuit or vith Ser~ice
or Feeder Permit I
$ 2 . 00 ..J:...:Q 0
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
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
OWners Signature:
:;lrt,oo
I. ~~
~? is
DATE~-------r--~-7,1--<:f~~~c:r~--~
RECEIPT 1I:.r\... :::X ' _ UJ"l'.15::....
RECEIvED B~JL)(A.:-f--~
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL .