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HomeMy WebLinkAboutPermit Electrical 2000-8-3 -e . :~;. IS;, ('/c-.- Date <j( - "'J - (J"i) \ Authorized Signature ~0 Zoninn AMT RECD:2 $ 38.50 CHANGE: CASHIER: 059 ELECTRICAL PERMIT APPLICATION City Job Number ClO-D I IQ.:2.-() { 225 FIFTH STREET SPRINGFIELD. OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION "'>350 Gq~u)Q'" s+ LEGAl. DESClUPTION 1-:::rc9 ~9..d,d, () n l::wn 30 COMPLETE FEE SCHEDULE BELOY Ao New Residential-Single o~ Multi-Family per dwellir.g unit. Service Included: Sum JOB DESCRIPTION Hems Cost $ 85.00 1000 sq.!t. or less Each additional 500 sqo ft or portion Permits are ncn-transferable and expire ther.eof if licrk is not start<!d wi thin 180 days Each Manuf'd Home or of issuan~e or if work is suspended for Modular Dwelling 180 days. NOTICE: Ser'Jice or Feeder 2. CONTRACTOR INSTALLATION ONLyTHISPERMI...B,. Services or Feeders AU-r-H IbHAlln'slt'aJ..1ation, Alterations I, ORIZ~ -"" ",... ,,,':r Electrical Contractor Dr:1D<0 J;1J:r, c;:DUNDBfn~elo'cHi::ls-riNOR/( vv,vlIVlENCED IS PERM/TIC::~, Address 33 ?,~J., IV Ivf~Nv1~^_-_ OR/&09A.~EJP~~E* l'es~T -, ""MY PER/02pl amps t-oJ:@AO amps Phone-2!9.~-2.I./!i.CL ';;01 amps :0 600 amps 601 amps to 1000 amps SuperVisor License Number ~-~ Over 1000 amps/volts Reconnect Only Expiration Date 10-( -0 I C. Temporary Services or Feeders Constr Contr. Number 1-,;;'g111 ., '~.., Installation, Alteration or Relocation " .:-" 'ulesaaDO;~db "" '''4UHb./v.... (- 1<(<; --'5'ratlor'CAnto, fh Ythl1~~I;{'i~less , ~'''''''Y52.nn7. DserllteS6I \)\400 amps of Supervi in lliifh ~f:~,m b010throu!ft/l;9J!, , t, 600 amps ~ ,elll/. r - ~ 0 tarn CD/Jie9'61th "GQps or 1000 volts , _ "'l ., ^" tel,(NDte:thete rU/esb, ,""-' I, /:~,:,:~egOiIiJ/Jtiliry:M~ih~e c:.u its ?;1""""hA \bt'ili,~,""'(l-""~'::>1d"\ cation , AddreSS ~ 65 ~\'<IL,-, ~ New," Al tera non or Extension Fer Panel C. /_ ",.......e, " I i.{'C -:> r.rr One Circuit _.-1_ S 35.00 35 lty c;~s - Fhone__':JU~;/-.'> ~Ll)b Each Additional Circuit or with Service OVNER INSTAI.LATION or Feeder Permi t City CJ'~"Wi'-U- Expiration Date The installation is being made on property I olin vhi~h is no! intended 1D! sale. lease or rent, S 15.00 $ 40.00 S 50.00' S 60.00 S100.00 S130.00 $300.00 $ 40.00 $ 40,00 $ 55.00 $ 80.00 see "B" aoove .' $ 2.00 Eo Miscellaneous (Service/feeder not included) -Each i~stallation Pump or irrigation S 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res ----- S 20000 Limited Ene~gy/Comm ----- S 36000 Owners Signature: ------- ----I: -t-- -------- ------------- --- DI,TE: g(rloe RECEIPT 11: ,_~'t~L__________ RECEIVED BY; __ IJJ 5. SUBTOTAL OF ABOVE ; ~State Surcharge 3% Admin15trative Fee TOTAl. ~5,oc 'J .c-L "i /.05 -----3% . 5 6