HomeMy WebLinkAboutPermit Electrical 1998-3-10
1.
LOCATION O~INSTAL~TION. 4
;;119 /<..'/-M/y. ,<;';0&:'.
,
c r c.; fijoXllowing proJect .
. Zoning, and does not as aubmlllOd has tho to/IOWI
approval, I"lIC/UIre 8pGc1llc land use ,ng
.~ .
97477 Date,,"r-llJ.:..2...'6' ELECTRICAL PERMIT APPLICATION
726-3~SlclnaIure n \'V\. Ci ty Job Number q ~ 0 '2 cr 3
3. COMPLhl~ tLL-SCHEDULE BELOV
I
/
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
II O?, 34 /2.
DS7aO
Items Cost
Sum
Joq .o~SCRIPTION
~//'# F
Expiration Date
1000 sq,ft. or less
Each additional 500
sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days j:ach Manuf'd Home. or
of issuance or if work is suspended for ~~dular Dwelling
180 days. ~ vice or Feeder
-100 0'..0 ~
2. CONTRACTOR INSTALLATION_ONLY C'a ~a ?'E}1vi'ces or Feeders
j~ () J /' -1~~ v~~'allation, Alterations
Electrical Contractor .757#iJ'......lJ() .fS. '~~R~~cation:
Address 'j(:?O' tcJ~ 7 ~/ <?~? ~ir~~~. less $ 50.00
f ' i-~~~. t~400 amps $ 60.00
City 0~ Phone 72-'-?~Q.} 'E@J~~IS1O~.j\,qoamps $100.00
<--' / . -- 6M: a %}~ amps $130.00
Supel'visor License Number !1 {", 11 j OV,er 10 ~a~~ts $300.00
Expiration Date />> / /./f'.%" Reconnect (!)~~4-0V-S>1- $ 40.00
/ "J"j u C. Temporary. Se~ic;?s or Feeders '
Constr Contr, Numbel' .2. () - 72,- Installation, Alteration or Relocation
/i:? 1// 7:r
Super, . ing Electrician
$ 15.00.
$ 85.00
$ 40.00
Signature of
~
/........,/ .
Owners Name lUG /l. r: ~
Addl'ess (nO "I :::r:.~1 ~
Ci ty -W Phone Lf'l.lJ - (, (.'13
OVNER INSTALLATION
200 amps' 'or less
201 amps to 400 amps
, Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
see "B" abOve
volts
D.
Branch Circui.ts
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
I
$ 35.00
"3b,/
$
2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent,
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. ..lL '7." ~'. ...--
SUBTOTAL OF ABOVE' ~v ~
5% State Surcharge I ' 7~
3% Administrative Fee I'OS
TOTAL f ?II, sa.
Owners Signature:
D^TE~-------~-~-(l)~--4-~-----------
RECEI"}"~: .. 7,.."1 u [,'V
RECEIVED BY:. .. ~