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HomeMy WebLinkAboutPermit Electrical 1992-3-2 SI.IIING~IELO , fOf! tI1 o ~. ~~ ',O"to~ lti) '~ "" .,.~ 225 FIFTH STREET ~1. <1(f~O~~. ELECTRICAL PERKIT APPLICATION SPRINGFIELD, OREGON 974770",~o,>. req::t6",1tt. INSPECTION REQUEST: 726-31 . ''>9 'b.A.c~"~/Jt Ci ty Job Number C') I J ~Ljq OFFICE: 726-3759 ..q%""" O/~,>~fO/Io ~<\r, COKP~ ~ SCHEDULE BELOV 1. LOCATION OF INSTALLATION Pile/lit" (,,~Lj ( c.,,'X1o to/1/(1J.,q),[;, AVE. S.P,fh . LEGAL DESCRIPTION \1 C82.:23\ \bl 1&).. tot. /iAl;) ),/;'7" In 17 &;/?Iw/J/)A fJJ//}.S;::.z2 Nev Residential-Single or Multi-Family per dvelling rvice Included: uni to Items Cost Sum 1000 sq.ft. or less J. $ 65.00 no,OO Each additional 500 sq. 'ft or portion q 15,00 thereof $ 15.00 Each Manuf'd Home or Modular Dvelling Service or Feeder $ 40.00 JOB DESCRIPTION .1f1iu) NDlVJ..E UJJj3p.iG jTJu...(JH Permits are non-transferable and expire if york is not started vi thin 160 days of issuance or if york is suspended for 160 days. 2. CONTRACTOR INSTALLATION ONLY B. ,Services or Feeders 'Installation, Alterations or Relocation: Electrical Contractor ('./T.Y E J.EffJIQI e c.... Address 7'1::~/) Sow. 8'774 .2'12 - '1{..Io/f Ci ty f'oI<lLkN'C) 08- Phone ,:{jt~- bo7k Supervisor License Number :L~ - .;< S'~c:" Expiration Date '7/1 i'r~ Constr Contr. Number l't!l7'tl:l. Expiration Date 7/1/'iL 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less -L $ 40.00 o/'t7. ",eo 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 60.00 Over 600 amps or 1000 volts see "B" above Signature of Supervising Electrician /~ ____ f) ~ 35'12. S "'" v-- /' A C'~. D. Ovners Name \:1WC ~nO IC:::Il LUUq1. Address ~ {) ~ f.4i Ci ty ~ li\ 1I Phone '1 VA- 24ld2- OIINER INSTALLATI~N Branch Circuits Nev, Alteration or Extension Per Panel One Ci,rcui t Each Addi t ional Circuit or vith Service or Feeder Permit $ 35.00 $ 2.00 The installation is being made on property I ovn vhich is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 Ovners Signature: 2f35.&>o /"1. 25 "29<3'. 2-S- 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL DATE: l' - <- -'?l'2.. RECEIPT #: --=5:if?? RECEIVED BY:/7~ . ",or