HomeMy WebLinkAboutPermit Electrical 1999-8-30
NorlCE: _
THIS PERMIT SHAll EXPI~ 'r-'
225 FIFTH STREET AUTHORIZEDU' 'Itl.t.vi.fE;,0AlR~ERHIT APPLICATION
SPRINGFIELD, OREGON 97477 NDERTHISPERM~TI NOT t2" <;?
INSPECTION REQUEST: 726-3769 COMMENCEDORISABANI5e~ 'ff'umber l ,0 '( 2--0
OFFICE: 726-3759 ANY 180 DAY n R
'3~RIQ:8MPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION/) II
1Z'f'i I7Et /1..6~ 14:-' ,A. New Residential-Single or
Multi-Family per dwelling
Service Included:
LEGAL DESCRIPTION
11b'S'L3t.t'-( 0'/00
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
Permits are non-transferable and eKpire thereof
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
, An~I~IIVI",u,,,.,". ~;"4Ullt:' ,_,
2. CONTRACTOR INSTALLATION ONLyfo!l?w rulesii90PSe'rv:ices8ci1'1rFeede~s
-NollflcatlOn CenteIInsta\ll'a:tion~ 3Ailltera tions
Elec trica1 Contrac tor InOAA 952-001-0(,o~ IReil.q;cat,ion::52-001
LYNN'S tLtl; I HIl; uu"u, TU-U may obtain copies of thE: rUles by
PO BOX A 726-7895 calling_ th~ centE20,0J(amp,sJe.Q!'IEl~~!\e
;.._" ':;;.:::::: :" .,~oo numoerforthe O-:2.0).Jr;1!!,P.~y FPJtffPqli&.'Ps
Phone Genre' i~ '40:~namf1s~',t<2i160ti amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
JOB DESCRIPTION
S1=:(2. .
Address
City
Supervisor License Number
~35'1 -5
EKpiration Date /0/0/
f
CanstI.' ContI.'. Number //J 2- '3/ ("
IO/9r
I
unit.
Cost Sum
$ 85.00 ~GP
$ 15.00 7S'"'
,$ 40.00
s
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
EKpiration Date
, Signa~~uP13v~rician
Owners N~e /-E 5 f:uAlflff,
Address 3/1 S' wf'I/~/L-2/7-
Ci ty t&. ~ - Phone)lf S'~ S f ).v
OVNER INSTALLATION
D.
Branch Circuits
$ 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
The installation is being made on
property I own which is not intended
for sale. lease or rent.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
Owners Signature:
--------r--t-~-----------------------
DATE: ~/lo r ,
RECEIP'l' #: 'Os,1,7ILfl.. I
RECEIVED BY: ~tM/'
5_
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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