HomeMy WebLinkAboutPermit Electrical 1997-08-26CITY OF OFEGO'V
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BI,ECTT.ICAL PERI{IT A?PLICATION225 FIFTE STREET
SPRINGFIET,D, OREGON 97477
INSPECTION REQITEST: 726-
OFPICE: 726-3759
The toil
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City Job 1t t;+t:3769 '
3. COHPI,ETE FEE SCEEDULE BELOS
1 LOCATION OP INSTALTATIONln|^ i0tfi, J.fi.
I,EGAL DESCRIPTION
11 n3 D l).5oo
JOB DESCRIPTION
Permits 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,A:IION ONLY
Nev Residential-Single or
Multi-Family per dwelling unit.
Service Included:
I tems
A.
Elec tri
Address
ca1 Contracto
Ci ty Phone 'l4l -A%Zb
Supervisor L ense Number lbgb
200 amps or less t
201 amps) to 400 amps _401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect 0n1y
c.Temporary Services or Feeders
Insta1lation, Alteration or Relocation
Exp iration Date
Cons tr Contr. Number O 3?,+q
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Hodular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
Cos t
$ 8s.00
Sum
s 1s.00
$ 40.00
50. oo
40.00
55.00
80.00
ee ilBn a566
5o.oo
. 0. ts €hd,un,,.?rrn .
,B
c
$ s0.00
s 60.00
$100.00
$130.00
$300.00s 40.00
Expiration Date
Signa
0vners Name
Address
cir
of Supervis Electrician
g
Phone
200 amps"or less $
201 amps to 400 amps
-
$
over 401 to 600 amps
-
$
Over 600 amps or 1000ffis s
-Each installation
Pump or irrigation $
sign/outline Lighting- $
l,imited Energy/Res
-
$
-q
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit $ 35'oo
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
OIJNER ALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
40.00
40.00
20.00
36.00
9,,5o
r, 50
.r4. ooRBCEIVED
5
to-t -q9
,l
CTTY OF SPRING,I'1EI,D
Fire & Life Safety
1l /)- 4ll7o s 35 tZ - /)Stri>
-<
t ?'/ - 2, ro/
DATE:0s- 11 -q1
FIRE DAMAGE P.EPORT
OR
ELECTRICAL HAZARD
rll.
FROM:
SUBJECT:
Bu j I d'i ng Depa rtmen t
Spri ngf iel d F'ire Department
Structural Damage to Bui 1 d'ing
Address or 'location of bui I di no 1bL tory a"*
Name of or^Jner A I^^o nae-L
tTyoe of bu'i Id i ng
Estimated val ue of bu'i1di ng
Estimated loss to buildins
(Dwe1 1 i ng tore,I^JareS Se, etc. )
s 2g-O0 !--1
Date of fire 4-V1 - {)
Location of damaoe 'in build'inq
4
ov1 e*Wior
(Roof, l^Jal I , Exterior, interior, etc.
Structura'l weakness as a u]t of the fire
Burned rafters, Beams, Joists, etc. )
Additional pertinent information
)
El ectri ca'l Hazard
(l,li ri nq , 0ut'l
,r,?u) f'ao"1*/ C,l{
si
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