HomeMy WebLinkAboutPermit Electrical 1999-9-17
. . r ec as su .ml e as the following
zonrng. anD ooes n01 require specific land use
approval
Zoning C C.
Date q~ __
ZZ5 FIFTB STBBET S toe = ELECTRICAL PERIlIT APPLICATION
SPRINGFIELD, OREGON"'~'fffl Ign~e:rl__' WORK 0(;
INSPECTION REQUEST: 726-3769iH1SPERMITSH EXPIRElfiWE Jill) .Number 'l' I z,,1 b
OFFICE: 726-3759 RIZEDU E~llil,~!!f\M\T\SNUI
1. LOCATION OF INSTALLATION ~-:~ENCEDORISABA~MlbRCHEDULE BELOV *=
J.? ~O /'7~/N _ ph\lONell Residential-Single or
A\'II1Iov[JAY \;fulti-Family per dwelling unit.
LEGAL DESCRIPTION Service Included: '
(., 62 '1 J 4 I IJ 1k.61J Items Cost Sum
~.DESCRIPTION I 1000 sq.ft. or less
~ t..( Ctl~CA". f Each additional 500
sq. ft or portion
Permits are non-transferable and eKpire thereof
if work is not started within 180 days Each Hanuf'd Home-or
of issuance or if york is suspended forr\aWlequHoa~~~rttPvelling
180 days. ATTEI'lI\ON'.Ole\l~~,>,tneorse<rvr~\!oA.F. Feeder
I rilles adopte cO rules are set 1 _
2. CONTRACTOR INSTALLA~RRll'rcel1ter.ihO.~. h~ry,rE:e'$o'ti1 Feeders
NotIDca .001_0010thr ~g s~sJlal:iI!lffi'O'h, Alterations
E10e td <:31 Cont ra<: tor .MSJl!\~~~W_c~ n~tail1 COP\~tfi'~tJ\S~'01:l~1t ion I
Address 5511 MAIN OO\lU'\\~:g"'the cel1ter. tNot~tir2'" Notilicat\OI1
ca , 't- ""''''9011 ,y..Q~ps or less
l1umoellu, ','-. 1_800-33<201 amps to 400 amps. .
City SPRINGFIELD Phone 726-6fT0111s 401 amps to. tlOO amps
601 amps to 1000 amps
Supervisor License Number 3023S Over 1000 amps/volts
Reconnec.t Only
Expiration Date 10/01/RA
Constr Contr. Number 92506
S 11:).00
$ 15.00
$ 40.00
S 50.00
$60.00
S100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
,Installation, Alteration or Relocation
7J16/03
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 voits
D. Branch Circuits
Expiration Date
Signature of Supervising Electrician
-4 -' ~~ -.. ---.,
OWners Name ~Fd- .c:.A>;--~F /.h:: b
Address ?<9'96 /"?,,:..v
S 40.00
S 55.00
$ 80.00
see "B" above
.'
New, Alteration or Extension Per Panel
/
$ 35.00 J)_O<>
Ci ty -5" c:r /c.p
,<,.''''-, ~:'ii_ i .}t~ ._,,~~,,1:.~.:
One Circuit
Each Additional
Circuit or vith Service
or Feeder ~ermi t . ). $
Phone 7 y '7;"95~f
OVNER INSTALLATION
2.00
bPt>
not included)
B. Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
The installation is being made on
property ~ ovn vhich is not intended.
for sal~, l@asp or. r~nt.
OWners Signature:
DATB~----q~7/r-9--------
MCRI'I'T II:' 0 .., {"r <; <r
RECEIVED BY: C. /
5. SUBTOTAL OF ABOVE
? ,% S ta t e Surcharge
3% Administrative Fee
TOTAL
$ 40.00
S 40.00
$ 20.00
$ 36.00
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