HomeMy WebLinkAboutPermit Electrical 1997-5-22
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REOUEST:
OFFICE: 726-3759
I,. fl i d.)~~' Il""~' --,
2-.) ..n\.,O-
.ppro"'\., lC)
ZoolO9_ .
oo\.~/~ -!::J2-t ~
,rthorlZod S\goaluro '
97477
726-3769
1.
LOCATION OIAINSTALLATION
.2f? I bit/fa in 51-
LEGAl."'pESCRIPTION
/ 70;;~/{)OO:Jm-n
JOB DESCRIPTION
Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
i,
2. CONTRACTOR INSTALLATI~Y B.
Electrical Contl.'actor~~/,1 C:.,,- ?4c:;%-/?
, ,
Address pc,j. /t?~7
, .
City <~h,~9LM>hone
-f/ /'
Supervisor LIcense Number
,?z{--7]'tJ3
QkJ/ f
,../c:./../ h,?
,/ c.
')r,.-/7Z C
A~/ ht:
./ ./
Supervisi Electrician
Expiration Date
Constr Contr. Number
Expiration Date
Signature 0
h _~~ '
- :Vi" U // / D
Ovnr s ~ '/J)J..f ~ I~Vb(cr .
Address /7/fC2 ( /j1J~flcI
'~ 71{ h -rl:n ,
City
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE~--~=:2J'--~-~--------------------
RECEIPT #: 2c;tji~(
RECEIVED BY: ~
5.
-
"
ELECTRICAL PERMIT APPLICAtION
City Job Number q 70'8 J n
Nev Residential-Single or *
:::::::m~:: ::~::l~::O:nit. "
Service Included:
3.
A.
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular'Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less X
201 amps to 400 amps
401 amps to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Recoimec t Only
Cost
Sum
$ 85.00
'.
$ 15.00
.
$ 40.00
$ 50.00 5l2,tJ[)
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 I 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
,"
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included) ,
$
$
$
$
'SlJ" tJv
:<.')0
I. ')D
c;tf. #l
40.00
40.00
20.00
36.00