HomeMy WebLinkAboutPermit Electrical 2004-12-28
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ZZ51'IJ1TH STltEET 0 SPRINGFIELD, OR 97477 0 PH:(54I)7Z6-3753 0 FA..,{: (541)
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ELEL-rRICAL PERMIT APPLICA110N
C;tyJobNUJnbCTUl~z.uo4 - C/5Z0 Dale
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S~icC' Ineluded 0'1'<: ,,/;..& ~610'
." S~.JR'
1000 sq. ft. or less -I'~ $I~tlo.
Each additiomll 500 sq. ft. or I'Jq1v/'; C'lii/'}.- rOI/o
ponlon thereof ~ ...... .00 (f "9-. 'Jt..1i)9..
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. LEGAL DESCRTPT\O~- -
)70~uz'Zza ' - 0/600
.lOB DESCRIPTION J -
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Permlts are non-trnnri"erRbJe film expire If work Is Each Mllnufact'd Home or
nnt starTed within 180 days of "suan"" or if work Is Modular Dwelling Service or
Suspended for 180 days. Feeder
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2.;:fo,~~~1t'll:f~r1Y~lf(}JV91$~~' B.(S~r~1~_~?~j,-ej;a~~!';~~I.i~~o~;'AI.te~.ii';tJ5~r']l.
Elcctrical Con!t3etor C Cl..H; L. It- of" I C"L trl' '- 200 Amps orl.... $ 63_00
t'- 201 Amps 10400 Amps S 75.00
Add,..:s. 'Z-q Ii S 5; E- 1 S A. it.!' 401 Amps to 600 Amps $J25,00
\ \ . _ 601 AmI"' to 1000 Amp. $163.00
City \~\\ 5DO(U ,Phone 150 >-~ql'8~7 ~ Over 1000 Amp,.{Volts $375.00
Reconnecl Only $ 50_00
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Supervisor UCCI1se Number '2l-q S- ~ C. 2t~~~.ry;:fS~~:k.?'6r'~~~~et!S:iI};:~~t;'i?
, . NOTICE'
E"piT1ltion Dale to / II 0 '7 T',I" prr.MIT rn.taUaUoo, AlteratIon Dr Reloca'ion
. "V ~ SH~M;~I5J.!iet~ THE WORK
Constr. Contr_ Number ~~ - ~>'l ce~T~ORIZ,ED UNL111flAb,~)(Hroa~S NOT : ~~:~~
vvr'"V1E,~(;ED OR4Ifi AJi1.Il,Nlil6liofi@tP{)R $100.00
Expira.ion I)a.e 7/1 / () ~ ANY 180 DAY PEQ600 Amps orlOOO Volts see "'B" above.
D-f:~rf~~~9f~~it{;..>S.;:'::.'Lf.:;:-::'X:(";W'.-,;)<t;..,....
/VI r New Alteration or Extension .Per .Panel
Signal:;~up~i;n~::trician One Circuit
/ L - Each Additional CilCUit or wilh
I - I L Service or Feeder Permit S 3.00
OwnenName <;;A",5t" JAJt::\-t",,{~."J3Cr-f~
A~dr..' -=?o 130-: 1066 7 E_~~~~~j~J~~~~~~#Y~IM~#).~~J~il~si~~i1.;ri"
CIlY r--vU::r61IE Pbone A:rrENTIQt:I;"Q~~e Oregon Utllltv $ 50.00
follow n11e9;jOOl?~~;~%i~es are set for\h $ 50.00 S1l
OWNER INSTALLATION NotificatiOn~~~f~ffiij~R952-001. $ 25.00
The installation is being ntode on property I own wtlid,OAR 952Q\Ra."8b~iffh:'llt:im!'l5fl/!lle rules by _ $ 45_00
is not Imended ror .ale, !ea.,e or rent_ OO~~il~~~'1~~~(~~.~~~n~~5000 + SlIrclu.rge.
Owner.! Signatun:: num~r.~I.-.t9~~.t'l~)...:,:;,,/!;../<<.. 5D () 0
Center srio'6:a$-~~);;_-H' .... .
7% Slare Surch"'lle "> ,50
.10"10 Administrndve Fee S, () Il
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$ 43.00
Inspection Rcqueot: 726-3769
TOTAL
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