HomeMy WebLinkAboutPermit Electrical 1998-2-4 (2)
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The following project b
lonlng. and doee not 88 CUI mnted has tho following
apProval. requ III llpE>c"'C Ian" u..
225 FIITH STREET z~t/ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Dat8~ (\<3'(\'(\(\ 4
INSPECTION REQUEST: 726-3769 ' City Job Number ,'-'\ D\" )'-"\ ' .
OFFICE: 726-3759 AU: . ;.., j S/gnatwe (\ ~ ,-
3; ~OHPLe~~ ~i-SCHED~ BELOV
1- I{\~~N ~i\~ALMNON~cor
A. Ne'W Residential-Single or
- Hulti-Family per dvelling unit.
\~~~~PTIOm'1\~ Service Included:
Items Cost Sum
~~E?~PTION \~\o()l3' 1000 sq.ft. or less l $ 85.00 t'S
~ \ 0 r'l'Q..-- Each additional 500
sq. ft or portion A ?/J
Permi are non-transferable and expire thereof $ 15.00
if vork is not started vithin 180 days Each Hanuf'd Home. or
of issuance or if york is suspended for Hodular. 'DYelling'
180 days. Service or Feeder $ 40.00
2. CONTRACTOR INST:t:ION ONLY ,B. Services or Feeders '
I I ~ . 40'" Installation, Alterations
Electrical Contractor W$ f ed~IC-% V~6.:r Relocation:
rtJ "1/. 0',0. ~
oojt. ?-.I;~5 t::' v~ (C'-9,J~0 amps or less $ 50.00
~u~ V~ o,~) amps to 400 amps $ 60.00
c:nlfu'- Phone q ~~- ~Df4;-~lI ~()40'&~PS to,600 amps $100.00
-'~ ~<=; ~..to'll s to 1000 amps $130.00
Supervisor License Number ~~/q C; 'O()"1;- '()OJ)~ amps/volts $300.00
;O~ oR8<;o~~~ ~Rly S 40.00
Expiration Date IC>- \ - 9!? ~O^ "1~ uA ~
C. ~mp~~~r~~es or Feeders .
Constr Contr. Number qq <;1'1 Inst~iY~bO"rt<S>AHsration or Relocation
.-<'0 1-'0
200 amps"oT ~es? $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Address P. ().
City, ZlA.1erJe
Expiration Date 6 olD ."1(1
Sign~~f~p:rvising Electrician
Ovners Name ('h1flrJ1'ieiL Hml)
Address 9t~~ ~1Yl d\1~
Ci ty fjlYw'\9-- Phone M S' q ~
_ \\ ,llJ
OI/NER INSTALLATION
D.
Branch Circui ts
"
Nev, Alteration or Extension Per Panel
Miscellaneous (Serviceifeeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or' Feeder Permit
The installation is being made on
property I ovn vhieh is not intended
for sale, lease or rent.
E.
Ovners~Signature:
.,
DATE: -------- "d.4'. G( 8'. r \^ 0.\-
RECEIPT #: I V ~'t--o fu
RECEIVED BY: D\v-r..L/ v
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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