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HomeMy WebLinkAboutPermit Electrical 1996-4-26 ., "" . lb, followi"9 proiect as uubmttted h2s the f II 'l'c'{jll'f'l ......d ~ ~ 0 0 ...., 'tj, .;...... CI)..S not require spnr-lfic I d cP;J;ov~!. ..,~ an use Ze::-dr.g (, Q.... D"0,_1{ - 2- (p ~ ~() 225 FrITH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 974 77,uthoriz1X1 Signature 726-3769 1. LOCATION OF INSTALLATION 5'1/,<; M U,/AI 5T LEGAL DESCRIPTION ~.cf'~ ~<",.~b\\ /70.2.3'3'1:< 03300 JOB DESCRIPTION ..~\. \'<..t" _ \'Z.\o.cn'i:s.h \ - ~~\\ <:<<^",._ll~ 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. -:so\:, '*- d- '\ \ \ <=\ 'S CONTRACTOR INSTALLATION ONLY Electrical Contractor :'S,\-"'""c- ~ 1....+<\<:... Address -;)'7D I ~\i. \14.~ Ci ty ~.A\o....A. Phone (~0'31 ;;)3~3 \ Supervisor License Number ~t?~~ ~ Expiration Date /0-/-92 Constr Contr. Number 'ILl!?;)? Expiration Date 3- 1'1-'1P, . Si~';ze7~cian ~, /. I'<.\~~j:~;...- y"""" I,,'"(,.,~ owner~."~~e YI) (f:,,,o.v ~n'" -::::\" e{:......, L "''\- '. c.c::r...-Y\Jc""L - -~""""...\o...r'tl Address;.rsO() 5...... ~r"'~ ~'"'---. C'-. "1;<,0\ Ci ly~" ..-\-\......"Q 0" Phone OVNER INSTALLATION I q~04%g ELECTRICAL PERMIT APPLICATION ~:'J ,Job Number ~^ '* uni t. . . , 3. COMPLETE FEE SCHEDULE BELOV Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. it or portion thereof $ 15.00 Each Manuf'd Home, or Modular 'Dwelling Service or Feeder $ 40.00 5. SUBTOTAL OF ABOVE 5% State Surcharge 3%, Administrative Fee TOTAL $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation $ 40.00 $ 55.00 $ 80.00 see ttB" above New, Alteration or Extension Per Panel .' One Circuit \ Each Additional Circuit or with Service or Feeder Permi t 5 $ 35.00 3S"0 IDO<> $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outlifie Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 A. New Residential-Single or Multi-Family per dwelling Service Included: The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE~----i:t~~Z;:q-~------------------ RECEIPT 11: :2,a.nr'l RECEIVED BY: tN'_ ,B. Services or Feeders Installation, Alterations or Relocation: 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 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits I..\S~' ~,~'5 \ .'3<<;; , 1..\ P-,.""