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HomeMy WebLinkAboutPermit Electrical 1998-8-3 . . . I jecl as eubmmed has the The ~~~ not require speclf1c land zoning. ... ~ 225 FIFTH STREET approval, fl.. ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 zonill\l..iD, Cf JD,LD INSPECTION REQUEST: 726-3769 n, 'J AI{, Ci ty Job Number 7 '1 OFFICE: 726-3759 Dale,\) "~ ' , Authorized Signature ,~': :>8: deHEDULE BELOV 1. LOCflTION OF I~STALLATION u;~q9 (~/A";f/? A. NevResidential-Singleor Multi-Family per dvelling unit. Service Included: JOB DESCRIPTION 10QO ~Ji.~. or less :2 / ('e 5q.l-'-I J/DLt5 2- ~'e on laW r~ffl~~(\.cJti\li~onal 500 ;}l.rli7- J tEEN1\V"'~' t~dbythe<B[jl.g"fl ~fOfPOrtion iii Permits are non-transferab \dWtlJle~il~\l~ ihoserU\t1Ii~~Rr~~01' ~ $ 15.00 if vork is not started vi t ~&c!tlen~er'10throu@a6l4\fkaR~ '~yHome or of issuance or if vork is ~~dlCfu'tO , conielold!h!~ yelling 180 d in y obtain ... """""'~ 0 ,6 F d $ 40 00 ays. 090 You ma 'Note: ,,""'. " Rmrr ee er . o " the center. \ Ut'lity NotlllCa ",.m1\99 0 ellon ,..:,"".... 2. CONTRACTOR INSTALLATION ONLl'lerlorthe r OO_"s.~..a:>"""'.s or Feeders , nllm centeJis1-8 "1nstallation, Alterations Electrical Contractor_.d"L.I'5 (,u./'~ or Relocation: Address ')41 J. L(~.......... 200 amps or less $ 50.00 201 amps to 400 ~s $ 60.00 Phone ({~&"J~.9-E: 401 amMtlf<'\~0JQIm'Ps 5100.00 ~ S\-\~QJ.E~tru" ~9...wQQ~ps $130.00 Number &'7.fi'i:i\!".PERIvlIi OV~i~9~sYvolts 5300.00 . uOR\2EO U\}\lJ'C'rinne.c.tO~ty\"OR $ 40.00 / V ... I'" '7 ~ t-,Ui.... OR IS t-,et-,NU COIvI",t:.N~O 'T,~wary Services or Feeders /700 "'IWr,n~'1P.fIlli't'allation, Alteration or Relocation "", /- J ;1- 'f q 200 amps or less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" aoove ~Gf~:f~~~ 7)~ Of) () Ci ty ~L..1UU! Supervisor License Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician J)J,iLAAJ ~ Ovners Name--r!5 itA ~e+E f. Address /7/tv 15'2. Sf J..,4M:... Ci ty f (1 Q 'Z~ h ~ ~ Phone 49- C; -0'755 ZI OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: ~ATE~---~)f-:f--~2t~------------------ RECEIPT 11:' - l().<hq(IJ.I( RECEIVED BY: '/___ (j:I /,f /'0. D. Branch Circuits It ems Cost Sum / czs.oo W1Pu 5 85.00 Nev, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit Each Additional Circuit or vith Service or Feeder Permit E. 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 /Lf5.o0 7..2.') l.I'ili {50 '4