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HomeMy WebLinkAboutPermit Electrical 2001-4-23 ~ . S.tl1FIELD 225 FIFTH STREET SPRINGFIELD, OR 97477 To. lollow,ng project as submitted has thelollow,ng (541) 726,3753 lO~,ng and does not requore specif,c land use FAX (541) 726-3689 225 FIFTH STREET approval. LD YL.- ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 Zoning . INSPECTION REQUEST: 726-3769 H ~ !)'?J-O I' r; ty Job Number Of-DO Z7i..( - 0 I OFFICE: 726-3759 Del" ::f<1.A! AJLllUIILaci Signature ~......--eet..".i :.:.t.Lt:. l6E SCHEDULE BELOV 1. LOCATION O~ :qISTALLATION &-, 997 ( ~/It-C-ft?r2- A. New Residential-Single or Multi-Family per dwelling Service Included: , ~ DESCRIPTION aOL-02Z 3' 01'$10 D It ems JOB DESCRIPTION /'. -F", e..~ ~yV/A o-~ 1000 sq.ft. or less Each additional 500 sq. ft or portion 7 thereof v Each Manuf'd Home or Modular Dwelling Service or Feeder Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations or Relocation: Electrical Contractor~lI"~ ILBroc:, Address--.!:lO/S9 '~n~H W 1~Il,d City ~(,j Phone ')Ur7'n'f Supervisor License Number Llill c; Expiration Date 10 '01-01 Constr Contr. Number 70 'U~.?1 Expiration Date 10'01-01 200 amps or less 201 amps to 400 amps 401 amps to 600 amps. 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only unit. Cost Sum $ 85.00 AS. 00 $ 15.00 -:y), cO $ 40.00 $ 50.00 $ 60.00 . $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps . Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 $ 55.00 $ 80.00 volts see "B" above sru)L:GPervi~~::rcan . ~ers Name Sc-off .l-/cd.,ES GlA-cl r:-rt t i<, Phone '726 r I bf'! D. Branch Circuits Address New, Alteration or Extension Per Panel $ 35.00 bY77 Ci ty S Pf='D One Circuit Each Additional Circuit or with Service or Feeder Permit OVNER INSTALLATION $ 2.00 The installation is being made on property I own which is not intended for sale, lease 07 ren t ':' Owners Signature: Miscellaneous (Service/feeder, not 'included) -Each installation ' Pump or irrigation Sign/Outline Lightin~ Limited Energy/Res Limited Energy/Comm E. . 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL DATE: Ot.{ Z. 3, Ci ( RECEIPT II: 5D" RECEIVED BY: ,f', (( $ 40.o.Q, , $ 40.00i ::;j $ 20.~!f:.,., $ 36.QClJ;:ri~ 0..:;:;: ("') .-:2:>.. :D 1".,)""00 "'1" -:n I--L ::c t'> , t-;''--' r-"'o fT1:x:...........(.".JO \?S:;..~ 'J ~ ~o Ct"-1'T1 t.n c::lI......... ..............Ol--'--.,J