HomeMy WebLinkAboutPermit Electrical 2001-12-20
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22~ FIFTH STREET fne fOllowing project as submitted has the followilij-ECTRlCAL PERMIT APPLICA T]ON
SPRINGFIELD, OREGON9"IIJl1l7and doas not require specific land use 0 l-o(() 0 I
INSPECTION REQUEST:"1'I!l6~69 I f"'\t? City Job Number I 7 - _
OffiCE: 726-3759 Zonipg VV"-
. ~l 1::l01 3. C9MPLcll:.n:.c.SCHEIlULEBELOW
l. LOCAnONOFIN~ 'II ' ~
75:3 Old Au __,. A N..wRe.<idential-Singlcor
MnIti-FamiIy per dwelling unil
Service l.ncluded:
LEGAL DESCRIPTIO~
/70""\ 23f..{~
() 2(0 Z.
JOB DESCIl,IPTION
1f()1...s, e'
,JIrz...tL.
Permits arc non-transferable and expire
if work is not stJlrted within 180 days
of i=ce or if work is suspended for
] 80 days,
1000 sq.ft. or less
Each additional 500
sq, 1\ or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INST ALLA nON ONLY B. Services or Feeders
lnstaUation. Alterations or
E1ec:trica1 ContractorLtnh ;::; 'sAt" Y c: Ie (! ~r>C- Relocation:
Address.lf/O k>:p5' ~U'rY h"ty~ 2ooampsorless
b1 ('/Y> f'1917 201 amps to 400 amps
Civ,( WpPd...42- PhoneCo'7'-/ . /3 401 amps 10 600 amps
/' 60 I amps 10 1000 amps
Supervisor License Number /q C) 7..5-- S 0= 1000 ampslvolts
R__..~...~ Only
Expiration Date /0- t? / - ~ t!J if
, .-/
Constr Centro Number 9 ~ ~ '/{.j
Expirntion Date /- c:2 u - - dJ..::0
Signatute of Supervising Electrician
-(JUA- J3h~
Owners Name ~ -tr...-- 13JvW1t=s
Address :i:>4 B~,x -?f(Z S-
City ez,t&~ilc;r Phone -Jl(t(. z6/LJ
OWNER INSTALLATION
The installation is being made on
".-,,_.) I own which is not intended
for sale. lease or rent
Owners Signature:
~OO:(j3IHS\.J:J
: 39N\.JH:J
O~'60G $ G:0:J3(j 1W\.J
'WOG Gl :J30:31\.J0
L8vLOOO-I0:#SN\.J~1
C. T -.,..._/ Services or Feeders
Installation, Alleration or Relocation
200 amps or less
201 amps to 400 amps
O\-er 401 to 600 amps
0= 600 amps cr 1000 volts see
"B" above
D. Branch Circuits
New A1terntion or Extension Per Panel
One Circuit
Items Cost SUDl
~$106.00 lob
~ $19.00 ,b
$ 50.00
_$63.00_
_$75,00_
$]25.00
$163.00
$375.00
S 50,00
$50.00
569.00
_$100,00_
$43.00
Each Additional Cireuil or with Service
or Feeder Pcnni1 _ $ 3.00 _
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
SignlOu:Uine Ligbting
Limited EnergylRes
Limited Enetgy/Comm
_ S50,00
$50.00
=$25.00 =
$45.00
Minimum Electric Pennlt Inspection Fee is $45.00 + Surcharge>
S. SUBTOTAL OF ABOVE
7% Stale Surcharge
8% Administrative Fee
TOTAL
/1>2..
12 7'{
~Sb
f ZO 9 ,30