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: ~"
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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
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124- 1-0