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HomeMy WebLinkAboutPermit Electrical 1998-10-1 . . , znrllng. and does not'requlre approval. \ . ZonIno A.. i Data"j.e>- \-~.~ .Authorized 8Ign8lUItl' '\\ "/'Y'.. 974// 726-3769 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. . LOCilTIqN _OF INSTALLATION _) . <l<;/ 111/1I'L' L~/>.i G, , LEGAL DESCRIPTION I 7o.n 1.(2 I JOB DESCRIPTION; .;- LIRCu., f 0170(;, 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 Contractorr)u,Id:::(S Address /C,5 i\-bd ';"C:lV'\ Ci ty ElJCl.fY\(' Phone 4'85 -OQ22 . ...j Supervisor License Number 2 g to -5 Expiration Date 10 -'-99-. Constr Contr. Number 4Z g(p~ Expiration Date 1"2 - J{)- 9R Signature of Supervising Electrician ee.~ {;)~ Owners Name 120/1/4// !h.. / / Address 8'$"1 Mt:l1l1 ~ AI c.I Ci ty ~1l1"7 {,dl Phone 17Z(,~ O<j 7J OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: -------------------r,------------------- DATE: In/I.d? 17 RECEIPT It: h "1 / '" ~F . / / RECEIVED BY: v a.r WM/ ", "~"1UCAL PER.'iIT APPLICATION Ci ty Job Number 1 'if/) "5 7- 3. COMPLETE FEE SCHEDULE BELO\l A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home. or Modular 'Dwelling Service or Feeder .$ 40.00 C. Te~rldi~:'tYr~Sofi 18\9 rlcMflfsvb!-l,to I nlbiiOWYLfEM'9doPllili'OVlIie me~6n1fiittR1a t i on 211l8!i~I' f.lo<;:e'l.'9s' Those rules are ~tlA~ao 21(JP~ 2iQ,0lt;88f~g~, OAn 9S2~.100 0~~'4 u WYtAA!a' i"" vi ~;,e !!ll~~~o Overa!80gtfa!msrsn18[, ( lVlll't'gp!il@@e"B" above number for the Oregon Utility Notification Branch ~~(j~i~.9-800.332-2344). D. New, Alteration or Extension Per Panel $ 35.00 "3;- One Circuit Each Additional Circuit or with Service,l or Feeder Permi t "1 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm B. Services or Feeders rle.l. '. InstmNl'l'(i.~l), Alterations G C:\r-, C Intor Re'l:'M:ll't~.on: THIS PERMIT SHALL EXPIRE IF THE WORK ~g~ ~O~~~@~Q~tlsTlliG F'EF:M~ I~~~ 401 OOIt~~E.v-<C[l(j)Qj~J:A13ANnm.jE~~. 00 601 ~!1W~O(\?I^~QQ~Ii'fi1Ps $130.00 Over'" 1000 . amps7vol:ts $300.00 Reconnect Only $ 40.00 . . 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL / $ y 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 '1 3 . r}iJ 2.. '/'1 ~( :. tl'{.