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HomeMy WebLinkAboutPermit Electrical 1998-12-22 ThO following project as 8ubmilled has \he 200",g. alld does not requlre speclIIc land IllIO sps;,rovoJ, Zoning I ctf 225 FIFTH STREET Deletk/'2.;k/./Jr! ELECTRICAL PERMIT APPLICATION, '0' SPRINGFIELD, OREGON 97477 "16- INSPECTION REQUEST: 72&!~7~jSlgnlllure Ilrv. Ci tv Job Number l' f /3S 1.- OFFICE: 726-3759 '-"" '. . W'TICE: . 3. COMPLETE FEE SCHEDULE BELOII 1. LOCAT;rON OF INSTALLATtON P RE IF THE WORK 1,7 '? 6/"cr:r~ERMITSH.~L~EX~. N,~w ,l),e~A~ential-Single or AUTHORIZED UNUl:R THIS PEiMulTt;i0Family per dwelling uni t. LEGAL DESCRIPTION . ANOONSerY~ce Included: . It{, () ?-tJ ') / '/.. O(S"y(j<iENCED OR. IS AB "IJ I " It ems Cos t ANY Wl {'l1\Y pF.Rlnn. 2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders Installation, Alterations H Met< ATTENTIONlt)rS9J,o~ tAon: 'tOllOW rules ado ted :,' t "'quires yo~ ~o Address 313,0 CA......p C(l?'-l( (o2lltotiflca'ionc~l.ffi'~ 'OEl:Of'eWlUtlilty In OAR 952-00 _ 1y.,"! me f'o'e!looeartl~torth Ci ty 5 f{-() Phone 72{P. (r::oo~ You ma a'n1 !~~ CMI19lmps01. . calling the:6 amn ,'SPI.tlo o.t000rl<lllJlllbv Supervisor License Number 3577 - s.,"'l1berfo th~~f (t roe.tJilllpsiIJ~Mie r ll.~~d.tllll)}'l~tiflcation /0-1- 0 I Center IS 1-800-332-2344). C. Temporary Services or Feeders Installation, Alteration or Relocation JOB DESCRIPTION Sptt. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Electrical Contractor ED Expiration Date Constr Contr. Number 2. 0 -"-I 18" Co Expiration Date 5- '] \ -00 Signature of Supervising Electrician --.- .~} ~~ Owners Name v f (YJ. J . Ad d res s / t.f /J JttI Al/t.1l ( t:-r/'- Ci ty ~ bi4/ Phone OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent, Owners Signature: ---------------~7---------------------- DATE:. I~h't ,?g- RECEIPT 11:, . ~J>').<3~ RECEIVED BY: ",..r "-'A...I' 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular 'Dwelling Service or Feeder -L 200 amps' 'or less I 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits Sum $ 85.00 ~ 5- -z.. $ 15.00 ~ 0 . $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 '" $ 40.00 !fl_ $ 55.00 $ 80.00 see liB" above . . . ,.-....., "-."'-.... .' New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00 $ 36.00 /))."U /,7f t-I.~r" il. .'(0