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HomeMy WebLinkAboutPermit Electrical 2002-1-22 J 9.B DES CRIPTI 0 NT' jefl~!J. Jted has tJ~Po~o'WirTh orless !le\OC./A + ::JtJOJ+ J~~~ r~rrlspecifiC liiA€lllJ~dltlOna1500 approval sq. ft or portion Permits are non-transferable and ex~iM1ng ~ J 12<<-' th.~..!J:flf__ H ifv:ork is not ~tarted v:ithin ;8pO daY:~_~_~J;:~- D~ EachMa~~tfd ~ome or of Issuance or If work IS SUl}fCI,rde-crfbr' ~uJ Modular DwellIng 180 days. Authorized SignaturE .- .g--~~~~'Feeder Electricat Contracto~<:Ar1rn€<'''> 2: (rPcl-r,? fl(:'h-'tDS) Address q 7rtiP ;,.J}.\ V00 0 ('€- fit+V. City~~~16^e~Ione q 9<5 , 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTA/.,LATION . ~ c.0 (1 \ ~rDd ~ t";; I Jrrf ~ J.C] LEGAL DESCRIPTION 1703'"1 Lf/L/ 68300 2. CONTRACTOR INSTALLATION ONLY Supervisor License Number .~ L!11l 5~ Expiration Date 7 <"07. Constr ContI. Numberd.O ,)"0 C- Expiration Date 1'/.... (;J ~ n ~:eoi=c;e Owners Name;11 ~ !cpi.. c; p,~te/ Address~ <:){^Lt\~~A~(\,~ .~~ Citi3l:'Id\ Phone 7'1'7-1<)7 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owncrs Signature: .. ~ r>v~~\JJ O"? 0>" ~ 1J~ ELElod.KICAL PERJvl1T APPLICATION City Joh Numbcr 02..- Oeo 7(../... () f 3. CONWLETEFEESCHEDULEBELOW A. New Rcsidcntial-Single or Multi-Family pCI' dwelling unit. Service Included: Items Cost Sm:n $106.00 $ 19.00 $ 50.00 B. Services or Feedcrs Installation, Alterations or Relocation: 200 amps or less 20] amps to 400 amps ~Jf'''~~?';kfl 401 amps to 60Q.A\Ilim.W;;\iIJ\it'{i~ , r c;vs,~f~r':'~i.' ,..- . .,. 'c .. ~ig,AAlps..ro' 110uO iUltQS"y- w N"') t ,'I 'it' l';jr;;;:.\;~~\\ ~cr" l.JdfItl'';;'wLt';tK5tt~\Jl\: ,e..;)' \~""~...t:",.. Y..: _"" ^<::-c;:"'":t~' 't y~. _.~. " _'C.Jl'"':fillf-\il~ ' ',.. _':"~~,/'"}. r~~f.-)':4- ;;._ ~.:"'ti-.. L.JO ,.." kI _.. _'~'_". ....,. r~ .. (, ",_)L .... 'l\rn:I'Of1il,,,,'R!e of1n~~\Q~OON"),# - - y,\j,} '.l '" ,,' .~.,;<'?"""r:;~-"'" {){t -~i.;; t:\l:-~ \\ . ~~Cj\l. 'k",.,,\\tl''''u :",",.- 'l\, ;Wt>t,-,"-~~ ,', _' _,;. ,lv' . J;..9V~I?1!Y\~\i.ices or Feeders AN'! 'Hrrtstilliation, Alteration or Relocation -l $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ') ~ $50.00 $69,00 $100.00 $43.00 $ 3.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump 'or irrigation Sign/Outline Lighting Limited EnergylRes Limited Energy/Comm $50.00 $50.00 $25.00 $45.00 Minimum Electl"ic Permit Inspection Fee is $45.00 + Surcharges 6) 4. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee I.{'11 ~01 72 jf- TOTAL