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HomeMy WebLinkAboutPermit Electrical 2000-7-6 i(j,,(jI(jM o/j'I'lIg 1111-A :II1jj 'Il "O.ll /tl/I "(101 ''!Io , 0111 "'e o <1\ "0 '8"b 01. (JI/II/ 'G9" """ 225 FIFTH STREET "1"'''01) I S",90'''9S ,ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 9747''''.0',' 9,,% jI'./at, INSPECTION REQUEST: 726-37fJ1t"o,,, ""O',,;O~ty J()b NumberCO-OIOLf'7-:0 ( OFFICE: 726-3759 ~ 9 , ; 1. LOCATIOli OF INSTALLA}'ION --3:j 8 07 tl. () f d1f1 y t1I.L...ru'l L IfJ~~Ob2CX1D JOB DESCRIPTION - . J; lhi.lPll e n(JY(ll~/ >c' l'ili/ tf:l.{ I /) ,;ilL-O Permits are non-tr nsferable and explre if work is not started within 180 days of issuance or if work is suspended for 180 days. -; Supervisor License Number Expiration Date /1;702.. Constr Contr. Number ~ I te iU~~~Electrician_ ---- -,......, '------ Owners Name Ibllr.; Ld7f({7''/A~ Address p, 0, /l;;)f 1F.'5 Ci ty -Lx 101 fe.tv! it e.. Phone ..H11- Fj :j1~l Si OVNER INSTALLATION The installation is being made on property I own ~hich is not intended for sale, lease or rent. OIffiers Signature: --------------------------------------- DATE: 0"70~OU RECEIPT j1: '2-,-/'-{ 7 RECEIVED BY: ,,,,K Residential-Single or lti-Family per dwelling unit. Service Included: Sum Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular 'Dwelling Service or Feeder $ 85.00 $ 15.00 .$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation D. 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts --.... Branch Circuits 2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders (\ .' . Installation, Alterations Electrical Contracto~lV/f\lb"rL ~ Iv/o.JrOIUoQ 11il.9r Relocation: , I Address PD. (lmx 1./054<{ ,200 amps or less I 201 amps to 400 amps Ci ty r;'N9111L.- Phone2..<I/- 4'6431!7-'6 401 amps to. 600 amps 601 amps to 1000 amps ?j?J?;7 J"-G" Over 1000 amps/volts Reconnect Only $ 40.00 S 55.00 $ 80.00 see liB" above .' New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or ~ith Service or Feeder Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 not included) 40.00 40.00 20.00 36.00 $ $ $ $ to ,1)7) /./,0 ,I/O 2-'1- ,157) w.cJ