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HomeMy WebLinkAboutPermit Electrical 1999-5-7 . ' ~. 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 ; 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. ~