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HomeMy WebLinkAboutPermit Electrical 2000-6-30 . l/ v,,^ lot '/JtJ, W'l/ "gtJ Ollc9 I}q "'Ol 'I. 0'0& J6el o 8"0 1188" 'lIlo <; ". I '0 ~"'. .q" 'fIg 'lti-l1'ItOt:11} 11}0'1. ' 8tJl1 "811} 225 FIITH STREET ~o(j $.' "% lel1foqoELECTRICAL PERIIIT APPLICATION. SPRINGFIELD, OREGON 97477 'gill/I", "(j~811"';'9 , ' INSPECTION REQUEST: 726-3769 · City Job Number OD-O 104/\ -0 ( OFFICE: 726-3759 1. LOCATION OF INSTALLATION 3~&JO 0A'Ta.u4'-( Residential-Single or Multi-Family per dvelling ,unit. ~ Service Included: . 7'/t. O"'IC~ Items JOB DESCRIP1ION ,d,. rs,o<s :1000 sq.ft. or less $ 85.00 lt0SiN<... (3.) SIGIVS :.'U'f1.tOfy, t9-11/;Each addi tional 500 ~u~~ ~~D ''S'l\~I/t or portion Permits are non-transferable and exp.tre~~c. 4thir~b/~ ' if york is not started vithin 180 days800 ~D~'c'fi,ljManuf~d'.Home or of issuance or if york is suspended for ~Y,o<s~M8q~i?fS,D~~e1tfqgh 180 days. t9/tServlce'c,or'ilFeeder:iO.:,. '-', - ~<SD" '1:;'11,. t:r") l. t 2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeaers . . Installation, Alterations Electrical Contractor ESt.A Slb10 ~Au.l/JIN0 or Relocation: Address \"2.10 6AIae'A-rCJi 1<.1>. Ci ty ~).JGUJ f.. ,0(2.. Phone 495 -SS4,ftJ (p"'}j'it'5i-G." . 'L'"c.o." "Reconnec t Only , . D I'" \ O..,LI, , "Ill ' ~''""ltt: ExpIratIon ate v-. r......:.. . l.?eor{'"' ~jUI.... Co. --j" '. . '. " C." Tl!!llP'O'tary)t,~:ervices or Feeders Constr Contr, Number 20:.7}!j,CL$ ". -'/';'." 0 :I;n5tana.t~pri, Alteration or Relocation /;, ''710...." '-.. '" ~ . ....0'.;;8'- ~ "':1 'v'. " ,1, 10 I 00 ....., '\..'1 .... L,' L 11- ' "..t,).. Expiration Date "I :'.~.,< " 200"amRlia'8;;'less $ 40.00 . ' . .~.,v'.L'I.I.~Ol'amp.s 'tol400 amps $ 55.00 SignatU\e of ~ervising Electrician "~c;..:.oy~~:.:~,o,1'eto 600 amps $ 80.00 Mk ~ ~ Over 6009'3mps or 1000 volts see "B" above D. Branch Circuits Ovners Nam~ ~"D ~ /2.&0CTS Address P.O. a.(j'f.. 1:)zZS Ci ty &hEN~ ,()(L Phone 744 -94 04 LEGAL DESCRIPTION 1763.ISOO 01 SOl Superviso~ License Number OVNER INSTALLATION The installation is being made on property I ovn vhich is not:intended for sale, lease or rent, Owners Signature: --------------------------------------- DATE: RECEIPT #: RECEIVED BY: E FEE SCHEDULE BELOV A. 200 amps or less 201 amps to 400 amps 401 amps,to 600 amps 601 amps to' 1000 amps Over 1000 amps/volts Cost Sum $ 15.00 .$ 40.00 $ 50.00' $ 60.00 $100.00 $130.00 $300.00 $ 40.00 .- New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00~ Sign/Outline Lighting 3. -$ 40.00-<lMr.oO Limited Energy/Res $ 20.00fg~~ Limited Energy/Comm $ 36.0og ~ C"J .. '--l .. ~,;If{")o"J 2 :=: 5. SUBTOTAL OF ABOVE I OJ:T-- ~ 'I 7% State Surcharge 'Q.ofW;..t=.J:38 3% Administrative Fee 3'~~~NB TOTAL \ 12~~:-' Q ~ ...0"0000