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HomeMy WebLinkAboutPermit Electrical 1998-5-5 . " , ~prova\. -k~nl \' Dale C;/ '5-4 0 225 FIFTH STREE~~ Sl~",^ SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION Y"/Cj)J . n14-VU <1 r 'v LEGAL DESCRIPTION r7/72 '<2 1,? D/Cf'I/ , ;;-', JOB DESCRIPTION /"r rl/ <7'.&"/.///? IT"" ....' ~... 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor<;~.--//prprl-ll""/')MIYJ. s:AK.. Address ;::;'/). /-/J'y. 9~.., 7 Ci ty AFI1JJ'J Phones-v/- < Ji>9- to//O Supervisor License Number 21''1// -rIF Expiration Date //7 -/ -9C? Constr Contr. Number 9 - / 99 c/,::' Expirat'on Date /O-/-q~ \ I SigIJ ture of sup<<:rvisinj Electrician Y 0.. I AA'f /J iJ-t.k <-' J , ," Owners Name.A'P4/J -r p",JIl. TAl /YIr/.J..El( 1-- { ! Address s:>r9 V IN'=-// <, c-; It' P /l CitYSPRrfiJ,;.,t.rP-/l? Phone7~0;" 9/2.7 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale. lease or rent, Owners Signature: --------------=;r~~----.-------------- DATE: ~L!/ Y25> RECEIPTli: '.' "2..~? RECEIVED BY: ",y'/'" ..........., -, . 3. ELECTRICAL PERMIT APPLICATION City Job Number?I/~5h COMPLETE FEE SCHEDULE BELOV New Residential-Single or ~ Multi-Family per dwelling unit. Service Included: . . Items Cost Sum A. 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 .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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'OT less · 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "Bit above D. Branch Circui ts " New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35,00 $ 2.00 E. .Miscellaneous (Service/ feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 40.00 40.00 20.00 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ '- $ sh,~ /. VO' I_Of'. --3-r..-. ':2- ~ If ~ <h:>