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HomeMy WebLinkAboutPermit Electrical 2000-4-10 .\ . . SPRINGFIELD . . z . as su ml ted has the fOl/owing oOlng, and does nol require specific land approval. use . Zoning _ LT;> (L- Dale . I..{-- lb - hi 225 FIFTH STREET Authorized Signalure . ct)J SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 3. L LOCATION OF INSTALLATIO)\) /J. q f. '2 Jhr f(/K/ ;p /F'L.;q,c:f'c...Pf{ffE A. . . ).~ r # 3'; LEGAL DESCRIPTION . / 7/J ~ /'. 'it4< /)5'" t:, b/) JO}l D!>~CRIPTION II NfJ-. 1/ f/ U./__ Permits are non-transferable and expire if work is not started within 180 days of issuance or if. work is suspended for 180 days. 89 00 AMT ~ECD:2 $ 22.00 CHANGE: CASHIER: 003 ELECTRICAL PERMIT APPLICATION City Job Number ~ 9/3 If?' New Residential-Single or . ::::.:: :::,:":,' <- Service Included: Items 1000 sq. ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular 'Dwe11ing Service or Feeder 2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders 11 ;U .J Installation, Alterations Electrical contractorL'.ih,~~h/u-I.v~k or Relocation: Address;: 0'. f~..v// . 4'"or-~ amps or less /1 201 amps to 400 amps City(IA'~Ii/.t)~lt. Phone 7<t5-~~~- 401 amps to. 600 amps 601 amps to '1000 amps Over 1000 amps/volts Reconnect Only Supervisor License Number Expiration Date sf'. "~-[ju - C. Temporary Services or Feeders Installation, Alteration or Relocation Constr .eontr. Number (}6// C}ij(') Expiration Date ^I - rff - 0 0 Signa~of supervi~~ Electrician )tP Jiy (fl f)f:,ttu ~ Owners Name Address City Phone OVNER INSTALLATION The installation is being made on property I own which is not intended fo'r :?a1e, lease or ren t. OVri~rs.Signature: .. .....1, ~ I ....... L j' . ..:r).:j'- . - , ~,. -~--------~---------~------------------ DATE:" \:,. . RECEIPT 1I:.,... RECEIVED BY: D. 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600.amps or 1000 volts Branch Circuits Cost Sum $ 85.00 $ 15.00 .$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 $ 40.00 $ 55.00 $ 80.00 see "B" above .' New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res ~ Limited Energ~/Comm . 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 2-D ." I. 'i'-O . ,"6. ::!.2;ro ~."'" DUPLICATE RECEIPT DUPLICATE RECEIPT . -------------- --- ---..-----.- ------- ----.-- ---------------------------------------- CITY OF SPRINGFIELD 225 FIFTH STREET SPRINGF[ELD, OR 97477 (541) 726-3753 ---------------------------------------- ---- -- ---_. ---- - --------- ---- ------- ----- WELCOME 10 DEVELOPMENT SERVICES AND PDBLIC WORKS - --- ------------- --- -- -- --- --- ---- ------- ---- ------------- ._---- - --- ----- -- - ------ REG-RECEIPT:Ol-0DD1189 C:APR 102000 CASHIER ID:003 1:55 pm A:APR 102000 ---------------------------------------- ---------------------------------------- 1004 ELECTRICAL PERMIT $20.00 JOB~:99-0139B-01 1099 STATE SURCHARGE(7%) $1,40 JOB~:99-01398-01 1098 ADMIN FEE(3X) $0.60 JOB~:99-01398-01 T01A.L DUE $22.00 RECEIVED FROM: VENTRAL-FLO BUILT IN VACS CHECK: $22.00 TOTAL rENDERED m.oo CHANGE DUE $0,00 -------------- ----------- - .-----.-------- ---------------------------------------- *Pay Name :VEIHRAL-FLD BUILT IN VACS *Mail Addr' :PO BOX 416 *Cty/St/Z :CRESWELL OR 97426 *Site Addr :862 MCKENZIE CREST DR __________4_____________________________ ---------------------------------------- ---------------------------------------- ------------------- --_._- -- -- ------------ 'f unNK YOU!!!!!! -------------------- ----- - ------._------- ---------------------------------------- DUPLICATE RECElPr DUPLICATE RECEIPT ...