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HomeMy WebLinkAboutPermit Electrical 1995-10-9 . .' SPRINGFIELD Th. lollowlr.g proJocI.. ,"t<n:t1oo hsS tl1<l following .~oninD end ,jOC'-3 not r(lo=1u\r~ ~~;tftc le.nd use 225 .FIFTH STREET 97:4"1'07.0;"1.' .fIt) ) ELECTRICAL PERMIT APPLICATION SPRINGFIELD. OREGON P r/V fL/ INSPECTION REQUEST: 126-3169"il:\1....-:a- City Job Number '1.'::>1 ~9 I OFFICE: 126-3759 O":.__J~jqlg:2 3. 1. LOCATION OF INSTALllA'l1IONd Signature vI1 "9-=3~,~~/"';-~- v-- ,??_ ~ A. LEGAL DESCRIPTION ~::r~'2~~/,d)/~::5 JOB DESCRIPTION ~~~ r~~ ~...c>~~~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. New Residential-Single or ~ ::::::::m::: ::~::::l:::O:nit. ", , Service Included: Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Hodular Dwelling Service or Feeder Cost Sum $ 85.00 ~~,~ $ 15.00 -45,C>C $ 40.00 2. CONTRACTOR INSTALLATION QNLY B. Services or Feeders IJ ,r: / ':()--:I- Installation, Alterations Electrical Contractor On 11 n'7tU-JC.YJldA~ ~ or Relocation: Address) S<[) rL "f ~ hI-v l{ Ii w- Phone b$ q 7,n , /j q:z.., 5' City (-:::v'\<-~'- , Supervisor License Number Expiration Date 10- I - 'lift Constr Contr. Number '3 /,.,. J.-7~ Expiration Date f-)'5"-~ Signature of Super~ising Electrician- 1'UJ-J f-,w}vV' MJJI~ . , . D . Owners Name r;1.7Z'~~,4~~ . Address ~~'3~~ ,~.N?2M. City~ Phone~~_::v-;;b OIINER INSTALLATION ( The installation is beiri~\made on E. property I own which is not intended for sale, lease or rent. ~ Ovners Signature: --------------------------------------- DATE: J.t!?~ 9.,!! S-:' RECEIPT 11: /~~~ RECEIVED BY: /" ~~ ,.' 'r 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or'peeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Branch Circuits $ 40.00 40ea $ 55.00 $ 80.00 volts see "B" above New, Alteration or Extension Per Panel II One Circuit $ 35,00 Each Additional Circuit or with Service or Feeder Permit $ 2.00 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL' $ 40.00 $ 40.00 $ 20.00 $ 36.00 110'~ l'l,~ ~..o 183,leQ..