HomeMy WebLinkAboutPermit Electrical 1997-5-29
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SPRINGFIELD
The. following projecl as r.ubmitted hos lh,
zoning, ~nd does not requ~ro cpccJfic lr~n~
approve..
Zonj~ (' f I
225 FIFTH STREET Dolo 5-;)0 -77- ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Aulho,lzedSignelure fJM /)10LJ l //1
INSPECTION REQUEST: 726-3769 . -r-Ci.t) .:J..iu Number '1 - I 0( <.f/
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
520 I-IA-R l Cluj RoAf\
3. COMPLETE FEE SCHEDULE BELOV
'f. "
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
, 703 ;l;l1J1)(J:J fr,O~
JOB DESCRIPTION
f..j OO/{JlP 2m1j TENLPouJEL-
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
Electrical CO!1tractor RpA(""(')n ~l~,..rr;c
. Address 2585 Roosevelt Blvd
Ci ty j;:ugene
Phone 461-0291
Supervisor License Number 34855
Expiration Date 10/1/Q1
Constr Contro Number 38497.
Expiration Date
1/10/g:;;(
\/
Owners Signature:
~A~E~-~:~~-:~--------------------
RECEIPT 11: ,(5'1(0"[
RECEIVED By:n. ri1~/)A(')
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
.B.
Services or Feeders
Installation, Alterations
or Relocation:
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
Sum
$ 85.00
$ 15.00
$ 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 volts
$ 40.00
$ 55.00
$ 80.00
'see liB"
40.00
Signa,~~f" ~i.i"" "'. ctrician
'/I . ._~ D Branch Circui ts
OwnerVNam NoR:liB...v (;(l/,JxflWuTlON .
Address30o.q::..~~LAf\1&-' _
~ . One Circui t
Ci ty 5A-f)t77r IZ OSlt 'thone 707-52frJ-I../EiXJ Each Addi tional
,/ C-ft '-1.!::fKJ3 {; ..f-lIW!l.td srn ~ Ci rcui t or wi th Service
OVNER INSTALLATION t;1~ I:ut" ~ YtJ6 #'C.h~ or Feeder Permit .
, 11' , b' r..tldlvu(, IVA EM' '11 (S' /f d
The 1nsta at10n 1S e1ng ma e on q~D05I' 1sce aneous erV1ce ee er
property I own which is not intended -Each installation
for sale, lease or rent. Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
above
..'
New, Alteration or Extension Per Panel
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
40,00
2. ()(,
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