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HomeMy WebLinkAboutPermit Electrical 1998-12-22 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 The fol!owing p . ZOO;og . j d 'olee! as submitted has apP'ov~.' OOe not require 8pec1flc 1anU: ~" Zonina. ~ 97~7t, /'2-;/ LV ~<{ 7~WS4slnatu1'8 h -L..L ho--::-- 3. .( ELECTRICAL PERMIT APPLICATION. City Job Number \'Ul1t ~ FEE SCHEDULE BELO\I 1. LOCATION OF INSTALLATION I{ ';;' t'[5" ~ /", cr C1<- LEGAL DESCRIPTION /807-6)1'2- 6,too JOB DESCRIPTION (F fl- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Cf ~ /35>1 2. CONTRACTOR INSTALLATION~tSNLY'E' .B. Services or Feeders I II". InFtil.~i!t.~n, Alterations Elec trica1 Con trac tor ED THr.l,AiYP.KSHALL EXPIP6'rl R~~oc,!}ii~n:. . es you to Address 3/3/0 CA~O drJlltrRIZ~UNDERTfo\~~~~~~~~;~e6~:gonUtilit~ 50.00 COMMENGl:U uJ-lIS ~~~o T41m.e.fM/fs'l ""Q ~~lfo~h60. 00 Ci ty 5> fti) Phone. 7,24, '70.';-1-1) nlOrin 01Xl01l5ii~-@\l1ll>tiOi;lam.~9APdl5;?:-0~100. 00 n'''' . . 0090io.1.1LlU1l~ ottiaitOOQJ)13full!;mtl ,u,tlS 9130.00 SupeL"vi sor Li cense Number 3577" S c&1(~ttWOO1taDlll~llilS telepno~e$300. 00 nu~'i\Wl.M ~n Utility Notltlcatlol) 40.00 Expiration Date 10-/- 0 1 Center is 1-800-332-2344). C. Temporary Services or Feeders Constr Contr, Number 2. O-~I8'C. Installation, Alteration or Relocation Expiration Date 5 - J \ -0 <.') 200 amps' 'or less 201 amps to 400 amps Over 401 ~o 600 amps Over 600 amps or 1000 volts Signature of Su~~vising Electrician . .. .~.._- ~cJ. :::Kcv" Owners Name f fl1..t Address Filo /;J /-h"'/ZrSor Ci ty r-o 1I1M/ ([.lJlf/ Phone OVNER INSTALLATION D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 see tlB" above . . . ._......O.__M_.h " New, Alteration or Extension Per Panel One' Circui t Each Additional Circuit or with Service or Feeder Permit The installation is being made on property I own which is not intended for sale, lease or rent, E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm Owners Signature: -----------------z--------------------- DATE: /J.-!').2-/Cfy RECEIPT 11: 'P3A'2-f,(''' RECEIVED BY: t2f. Wtt".J' 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 //S~ ~, 7S '?", 124- 1-0