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HomeMy WebLinkAboutPermit Electrical 1994-8-24 C"IJ?I;(M. . j " , .. SPRINGFIELD Tho, followIng project ..submttt~~~ "'~... ~~_ I...'..... Z(':,:lg, and dOC8 not require ['I", er.'lJr01iDI. t' . 1. LOCATION OF INSTALLATION ~2'/,~~?7 . LEGAL DESCRIPTION I? '16~ ~ C; 4./'2 L>~~ 6" ,'. , - -~I' JOB DESCRIPTION . 1000 sq.ft. or less ~~~.::c::;. ~;fZI/~/#/?:5Each additional.500 " sq. ft or portlon Permits are non-transferable and expire thereof if work is not started within 180 days Each Manuf'd Home or of issuance or if work is suspended for MOQular,'Dwelling 180 days. Service or Feeder 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-~7:g OFFICE: 726-3759 AutMrized SIgnature Zonina 2. CONTRACTOR INSTALLATION -ONLY B. Electrical' contractor~.r/~"P ~~~ ~ AddressJ/~ _~ ~~ J?/'. City 6;~.-:;:~~ Phone-%!-~ ~ . 44-~ i-.HR- Supervisor License Number .3/t. ~-r /tJ!I /1(" Constr Contr. Number 5lO- "3>7(:, ~ ItJ/; /1 Sign~~?~;t~/~~ Owners Name I //./h7'!T./!F7't ~< D. r I .- ~.Al~ , Expiration Date Expiration Date Address City &sp,q;. z:::> Phone '7 ~ ;-r' '?:?/ OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners' Signature: DATE~-------~~~-~~------------- RECEIPT II: /V~t!? RECEIVED BY: ;/ / - - ___, l ',.,- - ELECTRICAL PERMIT APPLICATION " ,). Ci ty Job Number &:3 r/2 ~ '/ vVlitf::E'l'll--i'BE SCHEDULE ~ New Residential-Single or ".1'i-P,.i1y P" "",:::-:"" Service Included: A. It ems Cost Sum $ 85.00. $ 15.00 $ 40.00 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 $ 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 Branch c'ircuits $ 40.00 $ 55.00 $ 80.00 see nB" above " New, Alteration or Extension Per Panel One Circuit Each Additional Ci rcui t or wi th Servi ce or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder -E<ich installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res ' Limited Energy/Comm not included) 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00 t.--- $ 36.00 .%.. "%. -- /.s..f? /.ii>l!> ~a.g5