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HomeMy WebLinkAboutPermit Electrical 1997-3-10 . . ' Tha foJla.vlng project 88 IIUbmIIted heIllhe foI zoning. and doee not require epeclfIc: land U80 approval. Zonlnp (' {' Oate'2,.... K),-er; ELECTRICAL PERMIT APPLICATION 97477 AUlhu,lz8cISllllllltl '" (\ vv.. ' , 726-3769 ~' ' Ci ty Job Number q 7 I., d..-L/.- ~ ~~OMPLETE FEE SCHEDULE BELOI/ "Yfj., l....,.,..L...oCATION OF IN~TALLATION -?v)') il'~ ~. .. A~ lNt"',1I\ 3-rlPl) :- CO.. ~$%N\;i'" Residential-Single or &;:;. . "J).. -~ ~ ~l ti-Family per dlolelling uni t. '- ' ~ ~ ~ ~vice Included: <1 ~ ~~, '/- Q ~ "<~ ~ :fSI#~~ ft. or less ~ ~c~~ ~tional.500 . ~ ~portlon t e~. ~ Each a~~'~~?me, or Modu "'h~~~ng Servic~o~eeder 2. CONTRACTOR INSTALLATION ONLY B, Services or Feeders , 'I( 1 Installation, Alterations Electrical ContractorC8::x.J~ ~j ~(ed1.c. or Relocation: Address 9.D t&x ~d;;}C) 1 . 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 225 FIFTH STREET SPRINGFIELD, OREGON INSPE~rION REQUEST: OFFICE: 726-3759 LEGAL DESCRIPTION 17 0 Y;:,' '-/-'J- C> \d-.O'f) {V-ew .JJlJ?. AJ;SCRIPTIjlN t /Vc<:N\i ()V\ (oIQ l/1, &\'~fr Permits are non-transferable and expire if work is not started within 180 days of issuance or if IoIork is suspended [or 180 days. Phone .f!1J 55r'~3Fb( License Number 3COd-LI-5> Ci ty F~.ev-Z.. " SupeL'visor Expiration Date (d~ i Constr Contr. Number' ~~;'~ Expiration Date. f'~ Signature of Supervising Electrician //I~~A-~- ~:ners Name 4)e.1f t V~ if ' Address J.. q 0 'P{i.-~ ' Ci ty..lJJ. d-'>( ~ Phone Ql{;).-..1.1o ~ I OIINER IRsTALLATI~N The installation is being made on property I ololn IoIhich is not intended ',for sale, lease or rent. Owners Signature: --------------------------------------- DATE: RECEIPT D: RECEIVED BY: ':C-IO - "\7 ..2C,O'5!) c.:P')u.) Items Cost Sum $ 85.00" $ 15.00 $ 40.00 $ 50. ort fiL- $ 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 D. Branch Circuits volts $ 40.00 $ 55.00 $ 80.00 see "Bt! above " Nelol, Alteration or Extension Per Panel One Circuit Each Additional Circuit or IoIith Service or Feeder Permi t 10 $ 35.00 $,2.00'~ not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ if//), -- -t ""~O , ~...l!6 'F- (po 40.00 40.00 20.00 36.00