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HomeMy WebLinkAboutPermit Electrical 1999-9-28 . S<<GFIELD -I' . 5 submitted has the tollowing The following prOject ~ uire speci1ic land use zoning and does no req ZZ5 FIFTH STREET 'lPJ1ro~al J"O 1"- E7..ECTRICAL PERHITAPPLICATION SPRINGFIELD, OREGON 97417 Zoning- Oft; INSPECTION REQUEST: 726-3769 q- -t.-B- 6ity Job Number ~9~"'?"'?' OFFICE: 726-3759 Date , . rOd. ,; " ,Ml1lOfized Signature ::I. <.vMl'LETE FEE SCHEDULE BELOll 1. LOCATION OF INSTALLATION C;/51-1111;Ilnl.l.f LEGAL DESCRIPTION ;a. ..:>..2 -&tC-/": ~/.;;pt? JOB DESCRIPTION ''-(1,,;/(11. /Illrqi"f - ~/1'I.lrd1( Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. . A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items' 1000 sQ.ft. or less Each additional 500 sQ. ft or portion thereof Each Manuf'd Bome, or Modular 'Dwelling Service or Feeder Z. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders f) .' Installation, Alterations Electrical Contractor il//~!J,tI YI/II'~nt.# Relocation: Address P. [). 6o",.l/()') G/ 'if ,ZOO amps or less , 201 amps to 400 amps City tf, 1.1 q In 1_ Phone L/<j, e/ - tJ I) 7'1 401 amps to 600 amps , 601 amps to 1000 amps Supervisor License Number ~~:ll J/...C" Over 1000 amps/volts Reconnect Only Expiration Date /o/qq Cost 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 Constr Contr. Number 4'1.145 (\ Expiration Date '-1/00 ZOO amps' 'OT less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 S 55.00 $ 80.00 volts see "B" above er/ising Electrician ~ D. Branch Circuits Owners Name ;.In/hay I'lJiI<"fo'J1l'fi(J"" Add ress {J, (), /J;/) " 7:l, l/ I City ?( f/9(r71 Phone I.tg'?-t.fJ~O OllNER"INSTALLATION " New, Alteration or Extension Per Panel One Circuit 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 Lightin~ Limited Energy/Res --1-- Limited Energy/Comm Owners Signature: --------------------------------------- 5, SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL DATE: RECEIPT II: RECEIVED BY: q-~e'7-"? ._~~~ - 7Z .&"~/ r r // ' $ 35.00 $ Z.OO, not included) $ 40.00 $ 40.00 $20.00 $ 36.00 'LO ' 00 I. t.((/ .uO 'l- Z-. no '/0.00