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HomeMy WebLinkAboutPermit Electrical 1997-4-4 , S"GFIELD The following project as submalod ho.o lh., fo::oY/in ~ zoning. and does not roquire speclftc L..nC: U':J ~ approval, ELECTRICAL PERMIT APPLICATION Ci ty Job Number 0104.4 ~ 225 FIFTH STREET SPRINGFIELD, OREGON 97477 Zonina INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 Dme Authorized Signature 3. 16, . L. OCATION OF INSTALLATION .Q..L~ ivlr.'d\ c,\-(PI".t- ~lY1S~o\-2-. A. \~Iif.:.crnlO() . , JOB DESCRIPTION " ." ,\ \ hJ{\(\ \ f\ d\-r..l 1_\ .d\ c.'J" \1v-tZX\ In ~ 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 Contractor F"StA Address \'?.lD ()/\1(,PA'1U;yU) Ci ty a)~f'Yle, Phone Y'3S-5i:;"l../ I" '...J Supervisor License Expiration Date Number Y?:'S ,<:,16 10 J q9 JII'L'6lo d- d. - q 8 Constr Contr. Number Expiration Date Signature of Supervising Electrician 1)/ ,~^'- rV'l- Owners Name Pi '\ 1\ H'\J+Vhl (IS c.e. ('\ +r Y'I (\ 'II~'" ~ \If) Phon~Lj7 - 3371..( Address blOloO Ci ty ~(),f'{) L - J- OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: - ----------------J[7\~ ----------- D~TE: \,\,q I \-- f"'. ~ RECEIPT II: .' .t,........\, ) ,RECEIVED BY: ~~...J L-/ COMPLETE ~..E SCHEDULE BELOY 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 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 $ 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 D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 see liB" above New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting~.. Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 no t included) $ 40.00 $ 40.00 ~ $ 20.00 $ 36.00 ~~ =is .1t-