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HomeMy WebLinkAboutPermit Electrical 2002-4-1 04/01/02 MON 15:56 FAX 5417263669 . 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST, 726-3769 OFFICE: 726-3759 CITY OF SPRINGFIELD ~001 ELECTRICAL alT APPLICATION Cily Job Number 0(-00 2>zg-of JgB DESCiJ,PTION / I ..<. 1000 sq. ft. or 1m h;"'~ /'IJ.____ /:;(.,(..(,1)./7);,/ 5 isJ~~as!iill'h>lld'lliliDlln1500 - The following proJec1 t ~:~u;: specifiC5~rft cW3'onion Permits Ore oun-lransferobleTliflO oiljlMoes no thereor if work is nol slaned wilhiilPRlO'll!.ys, (l J-.-- Each M.~.'d Home or or i"u.ncc or if work is suspended 1'61"109 - ' 0 1- Modulor Dw.ning 180 days. Date _ Il-p.-- ~ ;)crvlceorFe.der 2. CONTRACTOR INST AllJIlW,"elN~r.lVre 'il. Services ur Feeders L Installafion, Alterations or Electrical Contractor.!? LI? .5." ~7G-~ 5 Relocalion: Address L.-'rW /11<-- 51 SIc' 200 amps orle" < / 20) amps 10 400 amps CilJl.-.-'4../O'<t.....-' Phone Jv3 371- w 70 401 amps to 600 amps .,.. /. 601 amps to 1000 a~~\o Supervisor LIcense Nwnber '7 </7 ,j ~ /~ Over 1000 am~l.l~\\\\\'f RecolJl'f'ce1li~~o~ e\ \or." -. Ote~ \'(IeO e.\e~()()'- ~\o~. lted'Q)\!I'.1'~I'Sf.--,v~~.:(r ~ers Constr Contr. Number ::18 '10 3-.. ~'(;.~ ~ e.GO~~'I&WrQ~\\'C!1>ilr~""ation / ~o'll t~ cel'~ ,0 \'Ii \eS 0 ~e9"O. l' Expiralion Dale~ 1-t.G> f..Q. t:,J \O\~\ce.\\~'()O,"Ilm~i~If.~e\e o\i\\C?>\\Q _ ;I / ~Ol.\ p..9~" \}'.I~~~ ' . SigD22IUreorsu trvisingElcclrician il'O~.'/OU~ec~J..~uli' '.'" ~ ;L ~ 009 \}\\\1'9J~ ~\~CJ..~~i>sorIOOOvoltsset 4? /I d c ~el\O ,,~,h'bove d I-~..b-' flu(f\ eel' /' ~ II /) D. Branch CircuUs OWner! Name l:::reN esr c::::a,...I-r",- 0' ro. f r New Alteration or EXlension Per Panel Addr.ss_/lo icrzf~ jJAv~ OueCircuit ~~_ Citycl.,(A-,;, 0 Phone3/Z-9bO~S72 '1 E3c~~ion31cnCU~~~~\\S~O\ "7 . ~~ c.!J1l!.tAJlo.U- 'f\\S'? 1l).1Oo OWNER INSTALLATION ~V ~?\1>\\ '0" O'(;.?\ ~ - The inslall.rion is being made On \~\~iSC.e!l,J!!tol.\~\glr.~er nol included) property I own which is nor intended ~Q\1~1Jati'B'O Ii) for sale, lease orrent. P~~Ij(iYt88h~~'C.?\O . S50.00_ Slg\.l~\ijn.;<pllilllmg - _ S50.00 Owners Signalure: L~ Ml;;'rgylRes $25.00 Limiled Energy/Connn Z- $45.00 .J.a... 3. COMPLETE FEE SCHEDULE BELOW I. LOCA"fION OF INSTALLATION <()2..t-, ~T~J1..-.,. Si LEGAL DESCRIPTION )70327-00 A. New Resldenlial-Single or Multi-Family ptr dwelling uni!. Service IlleJuded: 02.200 Expiration Date Items Cost Sum $106.00 $19.00 $ 50.00 $ 63.00 $ 75.00 $125.00 $163.00 S375.OO S 50.00 S50.00 S69.00 SIOO.OO Minimum Electric: Perlnit InspectioD Fee is $45.00 + Sureharges 1:90: ~J3IHS\K) : 39NtlH8 OS'~01: $ G:083~ lW~ GOOi:: GO ~d~: 31tlO 08vBOOO-1:0:#SNIj~1 4. SUIITOTAL OF ABOVE 7"/0 Stute Surcharge 8010 Admini3iitrutive Fee TOTAL 90 hJU 7~o .lQ::> ~O