HomeMy WebLinkAboutPermit Electrical 1999-5-7
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Tr'? following project as su~mltted h~~ the following 'ti4;
225 FIFTn STREET z" ""9 and does not reqUire speCific land "i!tECTRICAL PERHIT APPLICATIOll
,ijlJprovat , /J
SPRINGFIELD, OREGON 9747/ , Q[~
Zoning
INSPECTION REQUEST: 726-3769 '5- '7- '1 "j
OFFICE: 726-3759 Dale , ~,
A..ilr,(.JfI2.eO Signature @A&
1. LOCATION OF INSTALLATION 1-/ 'Z ....
4o+n . (r mn 1 (\ () '''''''II' A.
ATTEN nON:OregoM'lOO roSltJifgs YlllStoless
. fOllOW rules adopted~'dhealldl!]bJJCU\II~y 500
: VU'"'l,;dllllfl venter. ThOfq!.ru/i:ls illIre ffilt~~i\nn
Permits are non-trensferable a'h~~?,!l:t-ij101-0010tht<hlgtelil~R952_001_
if york is not started lIithinOillJ{j. ~iiysnaYObtainE@plll!t\;l,1m(,'n\ld~ or
of issuance or if lIork is suspefiijI!!69!b~center. (Nd:iI.w.I"J\ll!el~ng
180 days. numberforth-e OregorS~"/{tYwoIllIC;i~\lider
Center is 1-800-332-2344). .
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
. . (j . Installation, Alterations or
Electrical Contractor ,-)( b t::L.P ('-j'y"IC Relocation: '
Address Z\'S1 Un n sf . 200 amps or less
S r 201 amps to 400 amps
City. ~"I n~"'t (j) fd Phone 54 \ - l %-4bS~ 401 amps to 600 amps
~ . 601 amps to 1000 amps
Supervisor License Number 3/~{)-S Over 1000 amps/vol ts
lIeconnect Only
Expiration Date In - \- 0 I
Constr Contr, Number zts 12. C;
Expiration Date 1...1-'2-'-1-- 00
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LEGAL DESCRIPTION
flfO.. )/ '1/ fJoL{(j~
JOB DESCRIPTION
'I?----vYl D ;) 0 n } ICE
Signature of Supervising Electrician
~~,,,...~
bu...VfA..Y
Ollners Name
(......."
I
Address
Ci ty ~,fJ
.
Phone
72~ - lfC['$';{
OVNER INSTALLATION
The installation is being made on
property I olin IIhich is not intended
for sale, lease or rent.
~
Ollners Signature:
D^~E~------;t7~r-------~--------------
RECEIPT I:~ /I iJ 3 jAior
RECEIVED DY: ~i.;.Jc4
Ci ty Job Number
('OHPJ.RTR PEE SCIIElJULE IlI!LOI/
Nell Residential-Single or
Hulti-Family per duelling
Service Included:
C.
q'l- oLf(11
unit.
*
Items
Cost
Sum
$ 05.00
$ 15.00
$ 1,0.00
$ 50.00
$ 60.00
$100.00
$130, 00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 1,00 amps
to 600 amps
emps or 1000
D.
Branch Circuits
volts
$ 1,0.00
$ 55.00
$ 00.00
see "n"
40. DQ
above
Nell, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or lIith Service
or Feeder Permit 3
$ 35,00
$ 2.00
. E. Hiscellaneous (Service/feeder not included)
-Each ills talla t i on
Pump or irrigation $ 40.00
Sigll/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Lind ted Ellergy/Comm $ 36.00
~o A(ivY\ SorQVUrco _1,2.0
5. SUBTOTAL OF ABOVE '-..)"- -
5% State Surcharge 2.l.)[)
TOTAL. ~