HomeMy WebLinkAboutPermit Electrical 2002-3-21
.
. . '.E..,
SPR -IELD ...... L~.. ~ L.-.
DEVELOPMENT SERVICES DEPARTMENT 225 FIFTH STREET
'-b')6 \ (/(/8~,so{) SPRINGFIELD, OR 97477
1'\ I O~ ~ L/ I \IOwing (541) 726-3753
U -- bl11il\ed haS 1M \~ use FAX (541) 726.3689
ac\ as SU , ecihc \an -:.'-
225 FIFTH STREET "he\O\\OwlngJ~~~ nOI ,eqUlfe sp ELECTRICAL PERMIT APPLICATION .
SPRINGFIELD, OREGON 97477 zoning and ~,. _ . ,,,,",,
INSPECTION REQUEST: 726-376!1>P'0"a\, ~ Ci t Number OI-00g5()1 -0 (
OFFICE: 726-3759 20nln~ '2-:( - 0 I' '.
SCHEDULE BELOV
1. LOCATION OF INSTALLATION Dale , d Signawe
30Z-b ~f'7 SliWlhOf\Ze A.
LEGAL DESCRIPTION
170'!. ZZO-c, DZ-COC
JOB DESCRIPTION
Ir::--wr P
p()v.f ~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
New Residential-Single or
Multi-Family per dwelling unit..
Service Included: .
Items Cost . Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion 15:00
thereof $
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00.
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders .
--Pj -'[ r n'),/' Installation, Alterations .
Electrical Contractor~r)J- \--:.CT..K.../.l../X7t"or Relocation:
Add:es~~()IoS'll.:-J. n/~ ~C9, .' ArT_EN &~'\!V~::~;;.r~~g:gg
City8JJen~.' Phone(a1L:f-c::.?Wto\1OW m ~~~~._ $100.00
/J Q -Notit~ . O~ €I . . $130.00
Supervis License Number\ "'/6~/x L) inOAR . llEietw= ~I $300.00
j. . 0090. YdUi \tie telepTlO1'" $ 40. 00
Expiration Date 10 I 1m callingttleCenter. UlilityNotitica:tIQIl
. h _ nliimb6\t!lllP~9J~@l(l.,S~. Feeders
Constr Contr.Number, J =t0R':t-e I@ltG!lJ'llah~-;jll!teration or Relocation
. . "5V .
Expiration Date I D/I J () I _ 200 amps or less $ 40.00 ~
~ ' 't ' 201 amps to 400 amps $ 55.00
Signatur f~ising Electrician Over 401 to 600 amps '$ 80.00
({)~ ..-/ Over 600 amps or 1000 volts see "B" above
J /' D. Bra!l,.ch Circui ts ' -
Owners Na!ne cre7V' (;"'Ol,./-J-L-... NOTlliC: _ INORK
r . .1 L Tl-li'j~EFt-.~~<&e.rtliloiiX8iRllJftW~i6n' Per Panel
Address :$0<50 (>-;fJ---n:.;;;-tv",,-? S,- , :'!'Uf'\8m:nlJNDERTHISPERMITISNOT
, AlOne-- rrc'Oft. . NDC"c:nl=nR$ 35.00'--
Ci ty :;f Ff) Phone ~/2-~O ~ $72 7c~~tAaar.tG'd~i\BA ..~
AN~~t;f\I,I'MV PE~~'~ Service .
OllNER INSTALLATION or"'Feeder Permlt $ 2.00
The'installation is being made on '\
property I own which is not intended'
for sale, lease or rent.
190: :mHS\:!::J
:39N\:!~ers Signature:
Og'Lg $ (;:a::J3ti lW\!,'
lOOl T7 \.lHI.I' '11 Hn '
19~80~~~~~lL------~~~(O-~-----------
RECEIPT jI: '25Jf.,t
RECEIVED BY: 1'.c<
-~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
. TOTAL
C)O --
35~
yO--'
K:;.'7) .:::.: