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HomeMy WebLinkAboutPermit Electrical 1997-1-3 . .- SPRINGFIELD.... " . :r~irf '"" ~ 225 .FIFTH STREET oale~ ~ ELEcmICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 A thorizodSi nature I< ,1M IIA ruSPECTION REQUEST: 726-3769 . 9 ~'~y '-w Number %/Y5Y OFFICE: 726-3759 . 1. LOCATION OF INSTALLATION €:>4c;" 11111IN ~, . LEGAL DESCRIPTION J]-4'~ ~C:;-,... ~/_ /~/tPt? , JOB DESCRIFTION l.J(M JVBu ~/I.-A/ n permits are non-transferable and ex~i~e if ....ork is not started' ....ithiri 180 da'ys .of issuance or if york is suspended for '180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical ContraCtor L.P, HtJtt'r/; 4r Address 4"~ '5lte[(~ "1'(2. Ci ty S ('ft? phone 7 117 -og II , Supervisor License Number ;-t.a-olC.-.5 Expiration Date 11)-1- tf'k Constr Contr. Number tJ( P3 ~ Expiration Da~e /,,-~-.'l7 siinatu~ of Supervising Eiectrician 'f Yf~ P"-r.fJ_-, ~ .~ !/ ..... 7.l. ~lImers N,\me ~ ......~~."a !:-".";U~C Address ~ 1./.4". :A7~~ Ci ty . ,"5~L./J _' 'Phone' .. - .;.- OIlNER rnSTALLATION The installatioh.is being made on 'property I olin .Ilhich is not intended for sale; 'lease or' rent. . 'Ovners Si~ture: DATE: /7 -I"}'% RECEIPT. ~: . . '=? ~d> ~'7' . RECEIVED BY: ..-'lJ j,.-.; '/Y .. "".' 3. COHPLETE FEE SCHEDULE BELOII A. Nell Residential-Single or Hulti-Family per dllelling unit. Service Included: Items Cost Sum 1000 sq. ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Hanufid Home or Modular Dvelling Service or Feeder $ 40.00 B. Services or Feeders Installation,' Alterations or Relocation: 200 amps or less $ 50.00 201 amps to ~oo amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 40-.00 C. Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to ADO amps $ 55.00 Over 401 to '600 amps $ 80.00 Over 600 amps.or lOOO.volts..see "B" above D.. Branch Cirttiifs Nev, Alteration or Extension Per Panel One ci r~uii .Each Additional . Circuit or Ilith Service or 'Feeder.pet'mi t $ 35.00 $ 2.00 E. Hiscellaneous (Service/feeder -Each installation Pump or. irrig~tioh' sig~/cii.J tlineLigh t ing~ Limlted Energy/Res . L'fm i ted . Energy: IComm not included) 5.. SUBTOTAL oiABOVE 5~'State.Surcharge .TOTAL . . $40.00 $ 40.00 41'6 $20.00 $.36;00 4P~. <... <>:!:!.. 't. oz..,~ -- ':.. .' 1.-0 -\- '2Ph t'Offi"f\ ~.e.: A '1,