HomeMy WebLinkAboutPermit Signage 1999-7-9
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The following project as submihad has the following
zoning, and does not require specific land use
approval. . ~'~ ELECTRICAL PERMIT APPLICATION
97477 Zoning 7 "'I _ ~ ,
~~-3769 - ,
~
.l. W/lPLETE FEE SCHEDULE BELOV *
A. New Residential-Single or
Multi-Family per' dwelling uni 1. , '
Service Included:
g S' ;S _ Items Cost Sum
-n"'O~.Q.>'
cQlo;r:.""-,:-j
JOB DESCRIPTION ~=:<:Il~@'n1sq.ft. or less
"S.lCt/l^--- \!leE 0 ~a;~~additional500
. ~ '(,f 0' g. ~ ~::l @.gft or portion
Permi ts are non-transferable and ex~.;e ~ Ql g lb'~~eof
if work is not started within 180 d~~ ~~ 7' iE1%tOManuf'd Home or
of issuance or if work is suspended ~Qf CD g g ~ ROdiHar Dwelling
180 days. 0, ~ .: ~. 0 :;!S&~ice or Feeder
~g~Cl~g~~
tl c CD ~..g <lle:i-~ ces or Feeders
~ g, So ~ cg. iIn~llation, Al~erations
f:lcctrical Contractoro",+:.. Dr4/. ~1t~!a. 0 ~rOl !l.location: "
-ifi-)>o.>co....
o -:F':n..., Q)
Address :2." 'I ;;r,,-rk~'N ,\-r~ ';-" ~.g. ~ ~ %08 ~mps or less
. ~. g ~ I}' 2IJ~ ~ps to 400 amps
Clty nw:;~ Phone."IyJl.I-:rtf:i]Q <ll '" g 4O.f amps to 600 amps
. - ~ 7' 6D1 amps to 1000 amps
Supervisor License Number /6:2. Lt I25J Over 1000 amps/volts
. ~- , Reconnect Only
Expiration Date---L" /0/ ."
/ C. Temporary Services or'Feeders
Constr Contr. Number ','- Installation, Alteration or Relocation
_ ('1 ~ -l ~O amps
- c :I: 0))
~ ~ -l u; -=r1 amps
upervising ElectriciaA s:: 5 -0 ;arer 401
-r /1 '- \ ~ ~ ~ g:: lfter 600
/. I A"; Cl () N s:: .,
1) . (:) I. '!J (J {" 0 /1 ~ d ~~ Branch Circui ts
O~ners Name~^- J11-g z ~
Ii 7'( en. ~ F New, Alteration or Extension Per Panel
Address~ ~ ( ~ ~ m
',f ne Circuit $ 35.00 '
City ( u-lc:::. Each Addi tional
Om:;; Circui t or wi th Service
ffi ~ -l or Feeder Permi t
Cl=1:I:
CS ~ ~isce11aneous (Service/feeder not included)
:0, Z 3tEach installation
~ ~ump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00 ~
Limited Energy/Res $ 20.00
Limited Energy/Comm$ 36.00
St'~O, -
225 FIPTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
i:i ty Job Number
,
Authorizad Signature
1.
LOCATION OF INSTALLATION
4::J /e; L .;?7t< ,'", ('+rd:t
LEGAL DESCRIPTION
110,,),,'3'2-3::1 O\qoc>
2.
CONTRACTOR INSTALLATION ONLY
Expiration Date
or less
to 400 amps
to 600 amps
amps or 1000
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
r
~;:-;"J!crr:!;-~;J:;i-~--"-". 5.
RECEIVED BY: ~ '/116<-- ~
f
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
qQO ~&()
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
volts
$
$
$ 80.00
see ItB"
above
40.00
55.00
$ ,2.00.
~
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