HomeMy WebLinkAboutPermit Electrical 1999-10-28
, ubmilled hes the following
ThetollQwing prOje~~~~:qUire specific land use
ZOning and does
225 FIFTH STREET approval .s:- C--
SPRINGFIELD, OREGON 97477 Zoning- \D' '"'\'2; .q9
INSPECTION REQUEST: 726-3769 ,d
OFFICE: 726-3759 Dete iQO
AumoflZ~d Signature , 3.
1. LOCATION OF INSTALLATIO~
-W '3R9'7- ~J(ZJn .'S"t A.
kEGAL DESCRIPTION
1'7 0# 31 4/ o).4cr-o
ELECTRICAL PERMIT APPLICATION
'City Job Number 0fq I Iq~
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
COMPLETE FEE SCHEDULE BELOV
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Items Cost' 'sum
,- _ . ." 4' :,; ,1\ . ... ;lllr3~ VOlll,;
r 1qQQ,~.q.Jt", or,,~essr;~' CoO ,. ~y 85.00
, Each, additional 500,_" " '1''11'
ill~ s,q: ttllol>portion~l \." ',' -l:fl1w
Oo",the~eo:f, ""-"". ,,,~sop.OO
Each Manuf:d Hom~9r' 'e
C'Modulaf'Dvelling } "','
nU'S'e'f'vJ:cenor'Pee!der" "'Utl!lcalifS'" 4'0.00
(.,. ....:~... -1'.01'-. ~'~_:P":~~
2. AlC~RJ~A~~~(;'Nl~OT ,B. Services or Feeders '
COMMENCEDORISABANDON~DFOR r- Installation, Alterations
El~'f'l8GbJW1!>!!illit5D.or-8.uLldP'" clectr,'c / l1~r Re10ca tion:
AddressiQS l\IIach:s.on 200 amps or less
201 amps to 400 amps
Ci ty Eu~ Phone 4'(?S- Cf12 '2. 401 amps to. 600 amps
, 601 amps to 1000 amps
Supervisor License Number Z'j1(}-:s.. Over 1000 amps/volts
Reconnect Only
Expiration Dace 1(:)- { - tl1!i! 01
JOB 9,E~CRIPTWN
nnp ('(/lr (J) t.
Permits are non-transferable and expire
if ~9.f.!l.,A~not started vi thin 180 days
of 1~!;,Ha"'~ or if vork is suspended for
18Ort4iI5lPERMIT SHALL EXPIRE IF THE WORK
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number 4 ''ZS1 {o
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Signature of Supervising Electrician Over 401 to 600 amps S 80.00
(JA"tl... R~ ' , 'Over 600 amps or 1000 volts see "B" above
~ q. Branch Circuits
Owners Name iU~ l}:J(1y, fjVtD~/E'S
- . ., New, Alteration or Extension Per Panel
Address 3f9 7- fV70 )/(1 S-+
Ci ty "Spr wrzf'.e.PrI Phone
OVNER INSTALLATION
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
Expiration Date
I 2 - 10- C/?
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
O\olTIers Signature:
~~~~;;(~~~~~~~~~-~---------
RECEIVED BY: n. IV)!/ t'MU U
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
S 35.00
?/5-dJ
s
2.00
not included)
$ 40.00
S 40.00
S 20.00
S 36.00
3'S.oO
/ ,f)
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