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HomeMy WebLinkAboutPermit Electrical 2003-5-16 , ~ "-,; { \-." i \, 'I ,! , r ~ ; I , " '-<. " , .;~ 225 FIFTH STREET;, -\ . : ' . " ELE.CAL PERMIT AP~L1C TION' . ' SPRINGFIELD, OREGON 97477! ' , I : ' ,'.~/. _L i . INSPECTION REQUEST: 726-3769 I! l:-'" ':Ci\y Joh ~umherc.o~Z..ca"- "QO Z r o~FicE: 726-3759. . :! i.', j .' ..J I ,i. 'j ,', ' 3. COMPLETE FEE SCHEDULE BELOW 'l.LOCATIONOFINSTALLATION':', :i! ' i : hlo 5c;~ J rn oses ',,' Oa...3CS I..... A.N~wResidenti;II-Single or' . U .Multi-Family per dwelling unit. LEGAL DESCRIPTION CO^ s\\'Ie\OIIO"'e'S'ervice Included: /707.34 { { { 0 () ~"b",i\\ed :~\iC land US n9 ?fO\01;\ ~.{e(\u\fe s?e \\\oltJ\ S{\O~ JOB DESCRIPTION l\'1e ~9' ~nd doe ~~ 00 sq. ft. or less I-I-rl ",--S (..J "O;,~t <Z.C _ _ 0 additional 500 . , , 0 l.on"'Y" &-~.J~ortion Permits are non-transferable and ex . ~ ~ler.e~fL if work is notstarted withmal%O days Si9na\Ule Each Manui'd Home or of issuance or if work is su~p.endea'for Modular Dwclling 180 days. Service or Feeder Items Cost Sum --.L $10600 ;06 Z $ 19.00 '_3...8'. $ 50.00 2. CONTRACTOR INST ALLA TION ONLY , Electrical'Contractorl"z:- t:: P;t.P.cJrt c. B. Services 01" Feeders Installation, Alterations or Relocation: Address ,'9oV;s;5J1 JO(l(JS A<..p[;Rd 200 amps or les; <' I i ~( , ./' . ", 20] amB~t.9400 amps City Jp-flo.,' Phone_9.'1:3-J.CZlB "~\l.(l.ll~~PO't~\'gjJ~amps , ,i , '. . /~ .\\",'I'I~;''l/ill91n~p.Ii,,,\JoDRamps Supervisor Licensc'Number L::J17'-1~S \"~O\ "",\X\e"O\;el}.']'OOii.anfp~volts .' v~ -',,, '9" "'~ " ii,i, / /. :>, IV'''' ~ev- OSe \\lRe~pmc~'i\.l\!)S , Expiration Date 101"( /..::tJ& ,.~c,1}.~\e~'''I;~ "to'->;~ O\'l.X\0t'{\O{\0 ,/ :'\\Cl'l-lW' Cefi\ ..oo'(I;f"TelllijOI'arYt~e~c~i>\Feeders h Constr Contr. Number / (J ~;<~n_f)fj.'I. :o\i\rili1'ti'!l,m*",.~Ji~l~tion or Relocation . r/- ~?'\\p.~"v l\\0.'l" :tet.~U'u\\\\\'l~cf\"\' ExpiratlOn Date 5'/ ~'O/~S(. -{Ou..he Cefi\ ote~al\2~:arilPs or less . ()U'" - ..,,\\\t\9- "at \X\6. \-'0(\1:'20 I amps to 400 amps Signature of Supervising Eleetricia\l\}~'Oe~ Cef\\etlS .-Over 401 to 600 amps " f\ Over 600 amps or 1000 volts see, Ftfl rn ~C]~ "8" above . $ 63.00 ' $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $50.00 $69.00 $100.00 C'I D. Branch Circnits ' Owne.'s Name Di'uc.0 IAJr'ecJ../h.J. O,slun-" lt~v'Alteration or Extension Per'Panel Address 337::J Pa.-V'~ tv>t1s t::oc, I?/rl.li.; One Circuit $43.00 " v, ~O~\<. - Citvt:Uq e.t'I-e... Phone (,,96- ~'1s"'8 Each Adg\lJ~ ~~ts~uqh Service . oj', ~\c.f.'. \.1?>1\.U~\>hl1,,~lJI\\ \ _ $ 3.00 OWNER INSTALLATION '~O' t.~lJII\ Sn 'J\ ,\~\S r ~t.\) tol' The i~stallation is being made on ,\\,\IS p O~~~lJ)iIl.~~I(18'll/iiNS~(flce/feeder not included) property I O\vn which is not intended t>.\.I'\\'\ t.~c,t.\) O\lEn<lrl\instollation for sale, lease or rent. c,OlJlWl \)1\;'1 ~\l? or irrigation _ $50.00 t>.~'1 '\~\) Slgn/Outhue Lighting $50.00 Owners Si~nature: Limited EuergyIRes _ $25.00 _ . Limited Energy/Conun $45.00 l\Iinimum Electric Permit Inspection Fcc is 545.00 + Surcharges 4. SUBTOTAL OF ABOVE 70/0 State Surcharge 8% Administrative Fcc I it..( lOOt{' 1L(40 I b j lJ12- TOTAL