HomeMy WebLinkAboutPermit Electrical 1993-3-1
T
. ~~
The foJl......:!r'" .... "r r'" .....'_ '.. ,
zon1o' - _' ' ..ur."!J. ~ -oj 1"'-' tfl'" '0" " I
. .;. C", ~ \.-;;;::, "t..~ ..~(" ..., .'_ . -:' "o..,ng
approval. ....1._.., ......1.';:; l..;na L::t
.
Signature of Supervising Electrician
~7\-11~ D. Branch Circuits
Owners Name ,LUll- U 1 Q ]),u)~
V\f\'~ New, Alteration or Extension Per Panel
:::;"~~!1 ',:::.!(zi:L17 _:,~:l,~o~';J . $ 35.00 .
O~\'l~~TION -*"ut~~i@~€~Fp~~~~ t S~'~~PY$~2c. 0sr-((ilJ~~:-~
~
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited,Energy/Comm
225 FIFTH STREET ';1 /'
SPRINGFIELD, OREGON 97477 ZC,'I~"____L_l.-
INSPECTION REQUEST: 726",3769 '3 - L -q")
OFFICE: 726-3759 J
Authorized Signature 3.
1. LOCA,\ION OF INSTALLATION
~lt MA-IN sr.- A.
I~GfJj,~~~;:tCCCfD
4- ~9)~JJsmM_
Permits ~~~::~:ferable and expire
if work is not ~tarted within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical' Contractor 1It:/('TA-~-E. G Fn:
Address -R~ \i ') ~~
City ftJQ<U\.Q.. Phone~C\J:IU
Supervisor Qcense Number Gt'\ ~
Expiration Date \C:>. \ ,C",f~ .,
Constr Contr. Numberlc/:2)\~f)
Expiration Date l~ .91 . q..s '
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATi~----~~~:~-----~--=-~--
RECEIFT, II:~I! " I U.o.~
RECEIVED BY: ' J l ^' /' --
- -- -
ELECTRICAL PERMIT APPLICAT~ON
City Job Number_q"-ljljl -
COMPLETE FEE SCHEDULE BELOV *
New Residential-Single or
""Hi-F..l1y F" ,,,mo, "0". '.
Service Included: A
Items Cost . Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
~!/
, .
(';"~'.~- .'~
$ 50.00 .~qJ.>--
$ 60.00 '
$100.00
$130.00
$300.00
$ 40.00
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
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
$ 40.00
$ 55.00
$ 80.00
see "B"
above
volts
5.
$
$
$
$ 36.00
,/1 rf),cD
( -<.' 0(./
G)!) -':2, . r.r )
40.00
40.00
20.00
SUBTOTAL, OF ABOVE
5% State Surcharge
TOTAL '
.f ,.-~..
.
.
BUILDING DIVISION JOB* 921241
ACTIVE
'-ADDRESS-'
5024 MAIN ST
-LEGAL-
LOT BLOCf(
-VALUE-
o
D17.SCR:800 AMP SERVICE
920904 / 920904
97478
-STATS-
BLDG ZONE
STORIES FLOODPLAIN
BEDRM OCC GRP
UNITS
f\~<'/", SQ FEET
{) ~'D~ CONST TYPE
1ft r:t ~~~NTRACTORS--
{J / ~'-'t~TRACTOR PHONE-.
1> 0s2 _ PLMB--
.. \/ \01- ELECT-RALPH BROWN
./\ MECH-
DESGN---
-OWNER-
GREAT WESTERN
~5024 MA IN STREET
SPRINGFIELD, OREGON
'726-2171
-ENERGY-
HEATl-
H20-
RANGE-
'1_
~
,- INFO-
NEW
5300
SEQ--REQUIRED PERMITS-------------FEE-SURCH,:i,E-DATE-RECEIPT-REPT CAT-------VALUE---
001-004-ELECTRICAL
130.00
6.5 920904 6114
500
$
o
SEQ-MINIMUM INSPECTIONS + REQUIREMENTS-----, --------------EXP DATE---ACT DATE-
001-041-UNDERGROUND ELEC
002-044-ELECTRIC SERVICE
, LT--INSPECTOR-
001--044-ELECTRIC SERVICE
ADDITIONAL PERMIT FEE FOR
----~--
OK 50
???
:f6
0./0
~