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Home My WebLink AboutPermit Electrical 1997-10-15SPRINGF'IELD, OREGOII p/(fli]' :onrtxi INSPECf,ION REQUEST3 726-3769 OFFICE: 726-3759 1 OP INSTALI,ATION SPT .GFIELO ETACTRTCAL PERHIT APPLICATION Job Number a- <a COHPI,ETE FEE SCMDUI,E BELOV Nev Residential-Single or Multi-Family per dvelling unit. Service fncluded: I tems Cos t $ 8s.001000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home- or -Hodular 'DweIIing Service or Feeder $ 1s.00 s 40.00 Services or Feeders Installation, Alterations or Relocation: ler zz5 rrFTE srREEf, n"'.]-Ql5_jf 3 .4. .B c- D. IJGAL Pernits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days 2. CONTRACTOR INSTALI,ATION ONLY Electrical Contractor Address ci Phone, /s{ 0414 Supe rvisor License Number E/A S 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 Sum s s0.00 s 60.00 s100.00 $130.00 s300.00s 40.00 Exp iration Date of / ing Electrician Expiratio " o^r" &*7-43 constr contr. Number {42/3 / Temporary Services or Feeders Installation, Alteration or Relocation 200 amps'"or less $ 40.00 over 401 to 600 amps - $ 80.00 or"i OOO amps or rbOo-vofts see nB. a661E Branch Ci rcui ts ; .- Nev, Alteration or Extension Per Panel one circuit Ll $ 35.00 Sry Each AdditionalCiicuit or vith Service;;-F;;i";-p"i,'it- -L g 2.oo 6 Hiscellaneous (Service/feeder not included) Owners Name .4nt-7./YA k>*rzz Address sr& Ci ty Phone OVNER INSTALI,/TTION The installation is being made on property I ovn vhich is not intended for sa1e, Iease or rent. OvnerHsignature: DATE: -Each installation Pump or irrigation _Sign/0utIine Lighting_ Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL E 5 s 40.00 $ 40.00 $ 20.00 $ 36.00 o RECETVED JOB DESCRIPIION;, ^-F -rl. 9& 225 FTFTH STREET sPRrNGFrEtD, oREGoN 97*-17 INSPECTION REQUEST | 726-3 i,,. .i-OFFICE: 726-3759 1. LOCATTON gF*, LEGAL DESCRIPTION 180 days. 2. CONTRACTOR INSTATLATION Electrical Contractor Address Bqq Ci ty Phone Supervisor License Number Expiration Date o Cons tr Contr. ttumber 5# Expiration Date Signa t Superv IS o Ovners i'lame Address I Ci ty Phone TALLATION DATE: 3PA F'ELE ELBC'TRICAL PERUIT APPLICATION City Job Number 3. COHPTETB FEE SCEEDULB BELOII A. Nev Residential-Single or Multi-FamilY Per dvelling unit' Service Included: I tems Cos t $ Bs.oo $ 1s.00 $ 40.00 €tr B Services or Feeders InstalIation, Alterations or Relocation: r less o 400 amps o 600 amps _ $ s0.00 $ 60.00 $ 100. 00 $130.00 $300.00 $ 40.00 i"000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder 1000 amps /vol t s nly r)Sum J Permits are non-transferable and expire if "ork is not started vithin 1B0 days oi i="u.nce or if vork is suspended for am00 ps ps o t tlt/,8 ryC C Temporary Services or Feeders Insiallaiion, Alteration or Relocation 200 amps or fess 201- amps to 400 amPs _- 0ver 401 to 600 amPs 0ver 600 amps or 1000lofts Branch Circuits Nev, Alteration or Extension Per Panel one Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit - $ 2.00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utline Lighting- Limited Energy/Res - Limited Energy/Comm 00 00 00 $ 40. $ ss. $ 80. see rr D B" a6oi6- o 60 The installation is being made on property I ovn vhich is not intended f or sal-e , Iease or ren t ' Owners Signature: E $ $ $ $ 40.00 40.00 20.00 36.00 SUBTOTAL OF ABOVE 5Z State Surcharge 3% Administrative Fee TOTALRECEIVED B 5 \ I Electrician a, q) ,t - 'rJOr /s' a o {-47 t3 ( t 23tvL-oqtroo4 n1u ',,j4'* a !-1O 000l7o FIRE DMAGE REPORT OR ELECTRICAL HAZARD DArE: L: l+ - ot1 TO: FROM: SUBJECT: Building Department /,tt. Springfield Fire Department Structurai Damage to Buiiding Address or location of building l+-1 Sou*i5 Name of ouJner f1o-bn^ B th-+tz- Type of building (Dwe'lling, Store, Warehouse, etc. Estimated value of building 0 Estimated loss to building $ Zr. oou.- Date of fire Location.of damage in building - n*1 (Roof, hlal1, Exterior, Structural weakness as a result of the fire 7U" etcnterior (Burned rafters, Beams, Joists, etc.) Additiona'l pertinent information ^5 o) Electrical Hazard t/tr+ S i gned qc' (!Jiring, 0utlets, etc. ) ,,, P1tr) sa 9- tu-q1I l! Y ./