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HomeMy WebLinkAboutPermit Electrical 1998-12-11 v 225 FIFTH STREET Dale )] -II SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-~SIslnahn 'KIA) OFFICE: 726-3759 1. ).OCATION OF INST T ON 7J. S ,uk Lbttt.9}' oi(v()1) e; - tf f! A_ "-~SOO I~ ("\D. 0 ~1'J4\ .(Y)~ JOB DE~PTION NOTICE' 1000 sq. f t. or less _ f!, ~~ ~ St~/.1Cp TI-II" nOR . Each addi tional 500 AI" - MITSHALEq.. ft or portion Permits are non-transferable and elpfr~'ZcD tfi'lf'ffOeJ./F.'T' if work is not started within 180J~!!\Yel/(" UND~ii'c,hllM'muffYCIllim.l!/(or of issuance or if work is suspe9,~~yd forA:D OR IS ~24~,fal.fRN.~~5t~r 180 days. "'. " I'"~ . _ Servi'ceJ(?rFFeecrer "fi.....,C) -, U OR 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders C <:. f\ 8t9('_~., _~ _ Installation, Alterations Electrical Contractor CO+- f-\ ;U:JT\......O or Relocation: Address \.~ \ f) ()A\::.ido-.-IcO\....~.. 200 amps or less ~n c 201 amps to 400 amps Ci ty V\JlU4'...,Q...O\LPhone L1'i3S-~L{(P 401 amps to 600 amps o C(ll-fOd- 601 amps to 1000 amps Supervisor License Number Lj 3 IS Over 1000 amps/volts Reconnect Only Zoninp a6 1.. ,.q'1 Constr ContI'. Number ~i::~~~(;S 10- / -~9 Expiration Date Expiration Date. Signature of Supervising Electrician ~A ....k_ ~ #1..{31 - -, //.. D Owners Name 1Lrl.,f;: WW7..IR~.. . -~; . ... '>.t.,. -', Address ('fld) \ 'bu..n~ 06..,", <iff 4cJr;, Ci ty ~tL:utb.... cq/J.. Phon<;' llr. ... 5SZJ1S'40 I OIlNER INSTALLAiFo1?O . The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: lliE:::::~m~~f------- ELECTRICAL PERMIT APPLICATION City Job Number q <61.5) 'K COMPLETE FEE SCHEDULE BELOV New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum S 85.00 S 15.00 S 40.00 S 50.00 S 60.00 $100.00 $130.00 $300.00 .$ 40.00 C. Temporary Services or. Feeders Installation, Alteration or Relocalion 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 S 40.00 $ 55.00 $-80.00 see fiB" above volts Branch Circuits New. Alteration or Extension Per Panel One Circuit Each Addi tional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not. included) ~Each installation Pump or irrigafion $ 40.00 Sign/Outline Lighting ~ S 40.00 ('ZO. Limited Energy/Res S 20.00 Limited Energy/Comm S 36.00 5. SUBTOTAL OF ABOVE l'ZO."" 5% State Surcharge (p ,. 3% Administrative Fee ;.~~ TOTAL /z.PI.~