HomeMy WebLinkAboutPermit Electrical 1999-8-3
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, ttPRINGFI~~
The tOl/owing project as b 't
225 FIITH STREET zoning, and does not r:~ui: ~ep~ h~s t1he fOl/owinlELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9'JlIl~al. CIIC and use ,Ot?
INSPECTION REQUEST: 726-378,~ing c::. ~ City Job NWllber~()9'7-r
OFFICE: 726-3759 Date '" - ? - C, i '
J rnKPT~TE FEE SCHEDULE BELOV
1. LOCATION OF INST~"_"'.!gnature \'G<.0
l'bb,S.- 'PIOVl"'<.,v_IX~vy(()w~\ ,t,,,,u A. New "".idential-Single or
LLJ~ ~ ~~ Multi-Family per dwelling unit.
LEGAL DESCRIPTION, Service Included:
J'i:)(L-Hk,u1 D,e, e.'1l'Vil~ Items Cost Sum
JOB DESCRIPTION 1000 sq.ft. or less $ 85.00
Wb........ ~ F-iU.-<--Sn;,Il(),jJc;. 9bU';' wi G.tc. Each additional 500
, sq. ft or portion
Permits are non-transferable and expire thereof $ 15.00
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
.' 0 ('! Installation, Alterations
Electrical Contractor-6; t' /J <)CbNl,QwWIPtor Relocation:
I .,:
Address l1.100l"fL PA.T(...(i '{Zep.,O ~T<t~:or less $ 50.00
" , tN's AI'!M.A~J>,QQ ~a~iR'" IFTHE WJJ'iJ,Ij: 0000
Ci ty .t\h'e?e,J'.?- IJfL---Phone -",/~t;~Wl.(", 4V'I atnpl!;"'t<l'r~ !jlRib I<$i\@~
mrf@'jlIl810U~ali1/lSPERMlT :sno:oo
Supervisor License Number l/ l\ Qv~~E!!JUlllI3'A\Il.ll!llUUI~l:uFcgjoO.OO
fA /01 R-€AI'tNy'6o'n,n80ecDtAY>~E~IOD. $ 40.00
Expiration Date V'f'
C. Temporary Services or' Feeders
Constr Contt'. Number f{fZ,9J~ Installation, Alteration or Relocation
Expiration Date sbo 200 amps or less $ 40.00
, 201 amps to 400 amps $ 55.00
Signatu~re of Supervising Electrician Over 401 to 600 amps $-80.00
Over '(600cam"psOor' ;1000,uv.Q..il ts see "B" above
_ .&.,..:... ~.a UO!leO!I!ION AI!1!1[1 uof5aJO a41 JOI Jaqwnu
oj) r'l"'17"'/ (\ IJA_ D. iB~Mttha,Cj,,;cu;i.)~)'Jaluaoa41f5U1l1eo
Owners Namell12..VL-- ~ ./fJ./n( . .~qsalnJaUljOS~!d?ou!elqoAeWnO^'06UO
/5/ ( 7 'fi\- -w~ej!i6~WiSe.!t'l~):qrJHPJ~Mlt!!JjJglJ'd'/l!r Panel
Address ;.) , 41-10,1 las aJ,e S81~J aS04.l 'J8IU80 UO!leO!lllo~1
f:. ? ) t(.., .~ q f - QV ,W'UJ,El L.%I6~~l.;!in Aq, paldope ~oln' 'AolfujJ5. 00
<., "" I \,{/ ( , oEachsAdd<l.t 1 onaI II .
City_/ U 'ih~Phon~ ."c,,, __",.".r'",o,.,.,l 810-f\1(,)IIN3' ''''
, Cl~CUlt or wlth SerVlce ~v
OIINER INSTALLATION or Feeder Permit $ 2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Miscellaneous (Service/feeder
~Each installation
Pump or irrigation
Sign/Outline Lighting <('.
Limited Energy/Res
Limi.ted Energy/Comm
'not. included)
DATE:
RECEtn: #:
RECEI.\~ED BY':
<ii-o-4 "'i
. '~O J<JI
~" '
5. SUBTOTAL OF ABOVE
1 ~ ~tate Surch~rge
3% Admiili.stni'tive;Fee
, TOTAL' ,
$
$
$
$
.j..W' J~, -
~ 1/.1.0
~ 4','6'0
~ 11(p.-
40.00
40.00
20.00
36.00
/t"l>,
Owners Signature:
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