HomeMy WebLinkAboutPermit Electrical 1997-10-13
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l"he following project as submitted. ~as tho followint]
zoning, and does not require tpeclllc land U;,l~
approval.. (/.
ZOOlna V
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Oete If).- , 3 ~fj1
97/,77 '
7 2~~~~ Signature
PY'A-
1.
LOCATION OF ~STALLA~GN
'l...::tO r IV I (J I ^ ,y~ A.
~~AL DESCRIPTlpNI7 17 Od 3) 3/ OSCe>OJ
Li/f}.."", e~({A ( Ihv<,,,{j \
J9B DESCRIP~ON tv/, ~ l/f k '"'"
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Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical CO~factor ~~4lt/IV/}/()
Address / /1 'flv (.-( ~J- .
Ci ty r;; tf'\ p/\/ Phonef; '1b~ 71 If]
"p,n',., ,to,"/, :VflPb J.Ct (;
Expiration Date .
Constr Contr. Number 3 ~o/)., c.
J)/qf1
Expiration Date
O~ners
Address
City
OVNER INSTALLATION
The installation is being made on E.
property I o~n ~hi~h is not intended
for sale, lease or rent.
u.re: ?/ (" _
.A L ~______
_ ~____________~______~____________ 5.
DATE:JD-I~....ql
RECEIPT #: 0:)' ~alp I
RECEIVED BY: r'Y. I C}/L(J. (.G-c...:r
ELECTRICAL P~~IT APPLICATION
(;1 ty Job Number G 7 I c..; q 5
3. COMPLETE FEE SCHEDULE BELOY
Items
Ne~ Residential-Single or
Multi-Family per d~elling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular D~elling
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
'Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Branch Circuits
"
Ne~, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ~ith Service
or Feeder Permit
$ 35.00
$ 2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/Outline Lighting~ $
Limited Energy/Res ~ $
Limited Energy/Comm I $
~
r
not included)
40.00
40.00
20.00
36.00
!E
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
- .
.....l1li I -.
. ]KJf
~
.
FEE
.
.- ....::"
ALAWfSYSTEK PERMIT - $40
CITY OF SPRINGFIBLD
DEVELOPMENT SERVICES
225 FIFTH STREET
SPRINGFIELD OR 97477
DATE: / DjIJ/11
IS THE ALARM SYSTEM BEING
LOCATION?
INSTALLED AT A RESIDENTIAL OR BUSINESS
,/
RESIDENTIAL
BUSINESS
v
If a residentially installed system, please complete questions
1 through 6. If the system is being installed at a business
location, please complete questions 7 through 13.
1. Name:AiJ ~U;~').IJ/J10rJ;; 1'11'6/1' ,
2. Address: .
City:
State:
Zip:
3. phone Number:
4. Date of Birth:
5. Is the ~ystem being installed by the homeovner? Yes No
If no, then indicate the company that viII be installing the alarm
system:
6. , Date of installation:
- - - - - - - - - - - - - - - - - - - - - - -
7.
Business name
(only if system vas installed in bUS~SS):
(;;Jyr: 4)~ m/lhl/f/' ~...!!..lP-
(5 rUt r r lrlll/l~ '
birth:
~/O
8.
9.
Ovner Name:
Ovner date of
10. Business address: ]? U \' .)//q,'1 (2....-
C"yo VI N ""'Q ~ Zip' 17./1.1-
11,.. phone Number: (, l( -" ~
'12. Company that installed }A:,rm system: ~ #~ p"A_
(,) / fJ UI(
13. Date of instal(ltion: J 0/ ! > /{j 7
t / / -I
ELECTRICAL PERMIT, REQUIRED
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