HomeMy WebLinkAboutPermit Electrical 2003-4-3
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225 nFTa STREET "',"~ AO.'
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SPRINGl"IELD. OREGON 9!,:1,/I ,'I>"
INSPECTION REOUEST: 11l(J<P~9 ","~
OFFICE: 726-3759 '1>00 ,/-0
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LEGAL DESCRIPTION
/703-ZbD (:) 230 I
2. CONTRACTOR INSTALIJTION ONLY B. service. s ,~rF~ede~ ,
, L'C' Installauon)' Alteranons
Electrical Contr.~ctor. n~f)~:r . )I~ or"Reio""a.t'f9'!::' '".,
1)_/ "v \I.lv ',- ..).
AddressJf)i n .~f' /Y ~_ ,,),A)2.06~~mpsc';r, 'l~~,~' ,: S 50.00
" N", \v\"e"oV "...~ps,'to :400"amps $ 60.00
CityrA AL{ rl, Phone (ow.,.l50u.<:,i>'" ",,40l.amps to 600 amps $100.00
, I ,IY" c.u'\~ \6oi' amps to 1000 camps $130.00
Supel'VL License Numberm/,,'?):liS .'U': .0,)\'\"9,".,r ,100~"amp~/v,~lts $300.00
/0) 5 ",\,",' .\,:,1. n,1 (R,!c~nneC't' Only $ 40.00
~ ' t' D " ~v ""'. ^', r r,',...r ~ -
r~Xp1r.(1 10n ate u " 1""\\-~' In\' \' c....,.. .......C r'
- L' CrT'" n. S' . ~F d
/)' /1\\'Q\\'-' f"~' \ empOl'at"y orV1C.es or ee ers
Conslr Contt. Number CY()-/(lIQ l' (",S>. .~':~ .,\\0,\~!;',stallatjon, Alteration or Relocation
v :\v.J (,...('
\\\~" " 200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
C JOB \lE~a:~F~ 1. .:v.., ". n
ffiY'D (l+- ~.b.::fj..U.1.iI (It ~-v.
Ferm;ts ar~ non-t~an$ulrable and expire
if york is not started within 180 days
of issuance or if \lork is suspenoed for
180 days.
Expiration !Jate
ID/IJ .~
~e~an
Ovners Name_~AlV PA-un~ ~TfD.
Address r3>63 \' f'(w Gfi-v'/::il 'Rd
CitY__'"~tAd Phon~u -5'7i-Z'tlriJ
OWNER INSTALLATION
The inslallation is being made on
property r 0101" ...hich j 5 not intended
[or sale, lease or rent.
Owners Signa tun"
__ ______ _____.__ ______.0 ~-__
DATE.
RECEIPT /I:
RECEIVED BY:
~\~(\~~~~
'CTRlCAL PERMIT APPLICATION
City Job Numbcr,I"(JWI'Z.~"~..::90060
COHPLETH FER SCREDULE BELOII
A.
New Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Itcm!i
Sum
Cost
1000 sq. ft. or less
Each additional 500
sq. it or portion
thereof
Each Hanuf'd Home, or
Hodular Dve11ing
Service or Feeder
$ 85.00
$ 15.00
,$ 40.00
$ 40.00
$ 55.00
$ 80.00
see UBII
above
E.
~\:)~\
New, Alteration or Ext~<{lJ~"I- Pa"el
~~ #' ('.~
One Circui t 9.~-,.<.R:~ ('i)~S 35.00
Each Additional ~ ~' St~'"
CiL'c\li t or \Ii~ ~'vi~
or Feeder n>.\.?-';l:R- ....~~ $ 2.00
~. ~~.~W~o(-v...-
~~~~.\S~~~e/feedcr 'not included)
Pu~~\~' ~\~~;, $ 40,00 - S<::>,
Sign~~t;t( ~'j)fght;ng--L_ $-'r(}.OO
Limil~~~~y/Res $ 20.00
Lim1te'<i~~CrgY/Comm 5 36.00
Branch Circuits
5. SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
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