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HomeMy WebLinkAboutPermit Electrical 1996-3-9 " It ~onlng l r1 V NOTI~; "() hll THIS P~MitsU~~L1xpIHl: IF lHE WO~I5ECTRICAL PER1HT APPLICATION 974WfHORIZED UNDER THIS PERMIT IS NOT 7t60-~7vii:tJCED OR IS ABANDONED FOR Ci ty Job Number ANY is/) nAY PERIOD. 3. COMPLETE FEE SCHEDULE BELO" LOCATION OF INSTALLA~ON 72(" MA-tAJ ~ A. Nelo/ Residential-Single or Multi-Family per dlo/elling Service Included: 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. LEGAL DESCRIPTION j 7/1 7, 1 !J 12 O~4' (l U JOB DESCRIPTION Permits are non-transferable and expire if I%rk is not started Io/ithin 180 days of issuance or if I%rk is suspended for 180 days. 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular 'DIo/elling Service or Feeder C;/'g j 2.- Lc:) * unlt. ' Items Cost Sum $ 85.00 $ 15.00 ,$ 40. 00 2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders [I ..L' Installation, Alterations Electrical Contractor'RlJlld:~(S eC:\r-IC Intor Relocation: Address I C)rs 10brl,',<:"CJn Ci ty ElJ~FY'\e Phone 4'85-0QZZ Supervisor License Number 29 to -5 Expiration Date 10 -1-99-. Constr Contr. Number 42. q(e~ 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 $ 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 Signature of Supervising Electrician Over 401 to 600 amps {1P.. ~ ~~ Over 600 amps or 1000 volts ~~ / . l' D. Branch Circuits Olo/ners Name /L.f'^,~ ~wreguiresyouto / lowruJ,esado.o.te..rlbytheOregonUtilil;M, Alteration or Extension Per Panel Address _/ Z 1:1 . ,^~.r.::n ront~h-';~A rilles are setlorth i ~52-001-0010throughOAR952-~,!-Circ~it r $ 35.00 "Jr Ci ty 5t? . '8BWlay gl;>tain C'T;o~ '11 the rul~ AddI Clonal , ~ ..caU" 9 the center. (Note: thetelephonEfuCUlt or 10/1 th SerVIce I ., OIlNER INSTALLA~Uril~erlorthe Oregon Utility Notilicatidlf Feeder PermI t $ 2. 00 ~ The iosta11ation is beiW~~d~1~O-332-2344k. Miscellaneous (Service/feeder not included) property I Olo/n which is not intended -Each installation for sale, lease or rent. Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm Expiration Date 11-Jn-9~ Ovners Signature: --------------------------------------- ?9.fC II RECEIPl H: U -116116, /J RECEIVED BY: AY tII/~ DATE: 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 55.00 $ 80.00 see liB" above $ 40.00 $ 40.00 $ 20.00 $ 36.00 17- Q'i) Uf r; , 1.11 <9.1(,