HomeMy WebLinkAboutPermit Electrical 1999-10-18
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REOUEST: 726-3769
OFFICE: 726-3759~\~~
1. LOCATION OF INSTALLATION
1125 Dale Rose
JOB DESCRIPTION
Alarm System Intsall
,
2. CONTRACTOR INSTALLATIONtyONLY AI
15ecun prus arm
Elec trical Con trac tor And Protection
O-'Z ..---
0:J 0 - (..~,
E C) <0 0 ",.. Q. ~ ELECTRICAL. PERMIT APPLICATION
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cr=,-<JJ",:Em //n()O C7 .
CD <3 0 <0 :::!; 2 Z Ci ty Job Number VJ~/ ( &
(')::.-c::Rjgro~
ffi. ~ 16 ~ i;: a? COKPLETE FEE SCHEDULE BELOI/
CD::3'g'<:1.::)CJ,.f-:
::.m::Jo:,.....~O
en b:;; g4:, ~ ~Vi Residen tial-Single or
c, (t) ." !!!. <5 -I~:1iti-Family per dwelling uni t.
LEGAL DESCRIPTION g'g z;; :T 5'Ser:vice Included:
f -->-" :>. / n ,"I I :s 0 0 ..... en '< Q:I I
I/)-' d'~ U Lj, 2> (; U ,,,) '-lii '0 0 CD :T :;: tems
VJe"' a;"c5 ~ (1) "'"
~~ ~ ~ C; lhOOOsq. ft. or less
~?lii ~)>~~c~. additional 500
"T' -' -::r:IJ -.. r;; (I) f .
.,.... ~.:g. m <0 CD :!q'~ t or portIon
Permits are non-transferable and expi~e5'~~~ ~h~reof
if work is not started within 180 dayg.~ m 62fach, Hanuf'd Home. or
of issuance or if work is suspended farCD cr::1 ::d10liular 'Dwelling
180 days. ''< , :; Service or Feeder
Address
P.O.Box 26413
City
Eugene
Phone 687-6474
3012 JLE
;!u 'n I vLt:
Supervisor License Number
Expi ra t ion Da te 10-01-99
Constr Contr. Number125673
Expira tion Date 10-13-98
Si~U~iSing ~~ician
o:ner~ Name Charactaes ,. 0
S ro
g
Address
835 Sand Ave.
Ci ty
Eugene
CD
Phone 354-9395
OI/NER INSTALLATION
~
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0>
C
ro
The installation is being made on
property I owr. which is not intenled
for sale. lease or rent.
~~. ~
__________________________________ _ J.
DATE: 10 - 1'1>.0, '1
RECEIPT 11: :3 U<" /4-
RECEIVED BY: 'K.lu
Owners Signature:
B. Services'or Feeders
~ ~nstallation. Alterations
oc Cbr Relocation:
oZoc
~ ~C@ amp's or less
F :g~ amps to 400 amps
u. ~vz aml>s to. 600 amps
jjj l!6O;B amps to 1000 amps
~ Y)vgr 1000 amps/volts
!i!< FBe~nn.ec t Only
UJoc~o
~ \!.!:efllPcli?ary Services or Feeders
:J: ?3nli:J:&ation. Alteration or Relocation
enooO-
.. ~ ~~ a%Ps' 'or less
~ ffi iiOlD~s to 400 amps
- 0- ~~ JIll to 600 amps
~ en ~vt5 ~O amps or 100U vol ts
ZF<lu<(
D. Branch Circuits
"'~...
"Og~
a.&2.
<. 6"
o>o>=;
. ::1__
~ Q.::J
" 0.'"
:::; 0-0
o (\) a
\ ~~.
0-
~ _0>
- '"
b"''''
- ~,& Miscellaneous (Service/feeder
,,~ ro ~ -Each installation
-ll ~ Pump or irrigation
g.6' Sign/Outline Lighting
~ s.Limi ted Energy/Res I
~~Limited Energy/Comm
0.0
cg
5.\\\ ~UBTOTAL OF ABOVE
~% State Surcharge
3% Administrative Fee
TOTAL
Cost
Sl
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00 ~
see "B" abOVI
.'
New, Alteration or Extension Per Panel
One Circuit
Each Add i t i onal
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
not includ.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
iu:1:
20.00
I.UU
.60
21.60