HomeMy WebLinkAboutPermit Electrical 1999-4-19
02/11/98 10:22
'8'503 726 3689
.
SPFD DEY. SER.
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IaJ 001
ELECTRICAL .~.... APPLICATION
. City Job Number 9'909'75
3. ~~~kFUS~~~~V ~
New Residential-Single or '
Hulti-Family per dwelling unit. ' ..
Service Included:
Items Cost Sum
,B, Services or Feeders
Installation, Alterations
Electrical Contractor .' ~ 0;. Relocation:
Address 20'S' W 2J., CoM/r1t:. ,~UNQER ~'2'6IJ:fl!Ifj~_ or less
./ ' "W,y..'bd...~~ TJ.mai.. alllf)!l:-I\f)~,QO amps
Ci ty !:.lJpe...h(, ~ Phone <l "t"'tV-'W~/~~.48~~J.~.q~o amps
superviso~ License Number /2.. 5l2O <; ~OD. over~f~~~~or:~s
-' ) I I } Re'connect Only
Expiration Date 1010 10 .
Constr contr.~i16~be.r,~,2.6 ~ 1'5rc...
O/~OWru Wit-",ur~
Expiration 8'fi~issi:!!1.s. ~, ,"'<4!wr"'~I' 200 amps"QT less $ 40.00
Af/ OAR si;' Sf/te";: :v The 0' -., "'S You t 201 amps to 400 amps $ 55.00
Signature ofl.sS\l~ /f;ifIgJ~ift~1,sf.'ilPgonUtil'tO Over 401 to 600 amps $ 80.00
C II' (j aYObt ' thro 'h eQsareset~/Y Over 600 amps ()r 1000 volts see "B" above
. _ . '1RQc.., Orth
7\; ,...' 'iii~':"(!lIot"':t~V(Th ruk;tJl. Branch Circuits ' "
011 Name -Lil _A>. --'-'- ~/",., by
./ . ,.t:lUO. C1''''~{'fJoi..?e New, Alteration or Extension Per Panel
Address c/I') v1t,/J() ~~Ait?lJf.A1/E:J6tJ
. " One Circui t ---1-- $ 35.00 35f'O
City Elk;; "7'7-ff)! Phone..fn~d- ~O Each Additional
Circuit or with Service
or Feeder Permit
. .
o require specific I OWing
and use. .
ZOning_ C:<::-
Dare _ ""''-f~ .
,- 9:1
225 S':;'~'::.lZea Signature
~J..tUl ..~...
SPRINGFIBLD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
~TION OF INSTALLATION
~..2.,/5 PUAIt1 ) "iT-i)NIT C-
LEGAL DESCUPTION
170Z~?_<2 n/9BQ
;
JOB DESCRIPTION ;
rJN.c: C!h"/,//Ir (Ad&'
;
Permits are non-transferable an~ expire
if work is not started.within 180 days
of'lssuance or H work'is suspepded for
180 days. I
2. ~NTRACTOR INSTALLATION
-
-
. A.
1000 sq.ft. or less
Each additional SOO
sq. ft or portion
thereof
Each Hanuf'd Home,or
Hodular'Dvelllng
Service or' Feeder
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation; Alteration .or Relocation
OVNER INSTALLATiON
,
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: .
a........o: 'I:
RECEIVED'IlY:
~-:;1.;i 5.
Cf. Ie;; 7'7
r f2l4Gf /" /I. l If'
tJ--( vAt'
I
$ 2.00
Hiscellaneous (Service/feeder not included)
-Each installation
Pump or 'irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5% :State.Surcharge
3% 'Adminis tra t.i ve Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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