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HomeMy WebLinkAboutPermit Electrical 1997-8-11 T'.,.... '(',"')v':'1C ..,~....:....,.t b' "'\ .' . as GU miffed has the follo\"in 7, (1/1\.1, ...rld tlQ;:- I':' roquiro specific land u . g ...ppro'./Hl. so 225 FIFTH STREET .li " ELECTRICAL PERMIT 'APPLICATION SPRINGFIELD, OREGON 97477 Zoninp--1!..~ DJ / INSPEcrION REQUEST: 726-3'l69t{-J/.ry CitYJ~b Number -( 0 Lf / / OFFICE: 726-3759 f/ ' Authorlzttd Slgnatur. !JI1 CQl1fLETE FEE SCHEDULE BELO\I A. Nev Residential-Single or Multi-F~mily per dvelling Ser~e&-\lncluded : ~~Y-~ ~O~ Items ~~~ ~ _,,&~ ,'0 . \.~i-~ ~'(OOO ~~\'-ft. or less _:\\Cf(;. ~c..Y-~'V 1?-~''O ~~additional 500 ~ ~~~\\ \\~~~ ~~~~~q. ft or portion Permits are non-transfera ~rrd ~tltPrre..,'O~ thereof if vork is not started vit ~~~~~~~~ ~O~. Each Manuf'd Home or of issuance or if vork is s~~p~~~~~~~ Modular Dvelling 180 days. c,o ~"" O~ Service or Feeder ~'{ ... 2. CONTRAcrOR INSTALLATION O~Y B. Services or Feeders ~ \..l f\ ,rt--;:"c:..Installation, Alterations Electrical Contractor f\ I lJ\( J:'\ ",D0\..i or Relocation: Addres's~ 0 f'f\ \ \\1Dd" 200 amps or less I C, flAt)... 111 n-, 201 amps to 400 amps ~ Ci ty U "G.Q1\O~ Phone I TI..J.:.1..id:lJ 401 amps to 600 amps ~ "~f)f'\Q 601 amps to 1000 amps / Supervisor License Number N" \::ilJ.;:) . Over 1000 amps/volts \1'\. \ . (\, (1" . Reconnec t Only Expiration Date \ , '" - . Constr Contr. Number \~~~ ).. .<t -lY6 1. LOCATION OF INSTAL!,t\T.ION ~'5l(JL( OhlWtfi1/ ~~ I /-)OGJ38fm.Yi4'l-/ JOB DESCRIPTION Expiration Date Signature of Supervising Electrician ~/~-4-7~~ ~~ame ~bt;)ff- (X6~ - Address1/{H7 en1d1 I / aw / Ci ty j '. Phone '1'17-({; 7 tJ (( m The installation is being made on property I ovn vhich is not intended for sale, lease or ren t. ~ -1 Ovners Signa ture: d q( ) ,I}'" f "I? /) &0';' . ~~~~~--------~~\\~C5Cf}--------~----- RECEIPT R: . { ~ ".l\ \\~ ~ RECEIVED BY: 'd'~-~-' \, \V....;'/ C. uni t. Cost Sum $ 85.00 '$ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 :S&'<PO ;z.~d. t90 /3<P.oD Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Circuits Nev, Alteration or Extension Per Panel $ 35.00 $ 40.00 $ 55.00 $ 80.00 vol ts see "BIl above One Circuit Each Addi tional Circuit or vith Service or Feeder Permit ~ .' $ /'fr'&.oo 2.00 Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL not included) S 40.00 $ 40.00 $ 20.00 S 36,00 f f5btP,tpo ?-r.d't7 ./ ~ . rc'" ~V9, J-O