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HomeMy WebLinkAboutPermit Electrical 1998-2-4 (2) . 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 I\SOG '12."'" I~~ ::j()