HomeMy WebLinkAboutPermit Electrical 2000-5-23
The lollowing project as submitted has the lollowing
zoning, and does not require specIfic land use
approval.. I /) fl--
Zoning :' .
91fa7J J;::' - .2..? - a'V
726-3769 . ~. ~
AuthOrized SlgnahJf€ -~
DATE:MAY 23 2000
AMT RECD:2 $ 22.00
CHANGE:
. CASHIER: 059
ELECTRICAL PERMIT APPLICATION
rity Job Numberj) ()'OO1J,I-O(
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION OF.I~STAL~TION C~
/I 0 ff' ,t)"=LrlJS c: 'L-
r~ O~f}?j2/ J/
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
JOiJ.OO
3. COMPLETE FEE SCHEDULE BELOY
Sum
Items Cost
JOB DESCRIPTION 1000 sq.ft. or less
~~u-~,'7"W. ~.s~..... Each additional 500
f . sq. ft or portion
Permits are non_transferable/anq~expire thereof
if work is not started withfn~~80?~ays Each Manuf'd Home. or
of issuance or if work is stt~e~ded~for Modular'Dwelling
180 days. . "t?~ "<~6t~'U01'b1 00 Service or Feeder
~ Q'~ <9", V6t~
2. CONTRACTOR INSTALLATION ONLY ~~6z ~&B.S'/Q"i,ef.V.~. c.es ~r Feeders .
;:::J ~ Q'-r~ (YGl l'Ii$:.~a . tIon, AlteratIons
Electrical Contractory/p'~/ .k_~ G.L97oJ..'R1j),.o G,1'?,;on:
, ~r:~S' v.;y~ 'YJztJu V",
Address _//: C) li'av F' OK"tj' -(,2Ji9.~'?n.&sL<rr less
...zWc'tIJlpS'p.to 400 amps
City eJ(~ &ITl Phone7~;1.,?t)6f: ~41l""ii'~'p.s to 600 amps
. 661;().\l!~s to 1000 amps
Supervi",or License Number ;sLr-of'. ~- Over'!fOOO amps/volts
Reconnect Only
Expiration Date /CJ - /"'-'.,%.Dt1_~
., c.
Constr Cont.. Numper';'t!JO "1~'nI,. .
., .,' j...., ,
Expiration Date 11-50- P"""O'._....,.(/I.t,). 200 amps"or less
. .:. ~" :'Yq, 201 amps to 400 amps
Signature~f Su . sing ElectriciaJ:l.) 'I. : . ;/;/~'<over 401 to 600 amps
~ ~""" .~. { ev Over 600 amps or 1000 volts
) \ '.?t.:'l
.' .,_ J., .'!.,.. va
~ "~.' 'D. Branch Circui ts
Owners Name ~tf~vTlz ~fZJ1(J .t;er." 'r.
o . . I IV.l
Address
Ci ty Phone
O\INER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT If: />15 f
RECEIVED BY:
$ 85.00
$ 15.00
. $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
see "B"
above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
.I
$
$
$
$
'2.. 0-
.
,.,.. -
40.00
40.00
20.00
36.00
",. J _
..