HomeMy WebLinkAboutPermit Electrical 1998-10-1
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.Authorized 8Ign8lUItl' '\\ "/'Y'..
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726-3769
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. . LOCilTIqN _OF INSTALLATION _)
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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
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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
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