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HomeMy WebLinkAboutPermit Electrical 1999-7-13 (6) .' Zoning 141, I . Data 1 /' In, Ci! q , Authorlzad Slgnatura ~f/Jj ATTEIilJON:Oregon la - U TO!'ow rUles ado ted w requires you to 225 FIFTH STREET .NOliflCation Cent~ Th by the Oregon Ut~hfCTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97!r1filAR952-001 00' Ose rules are set fOrlh \ ,~,," ' INSPECTION REQUEST: 72@9G7'68umaY~btl0throughOAR952_l3bH' Job Numbe ,. 7'"612./4 OFFICE: 726-3759 calling the cent aln caples of the rV'~.n' number for th er. (Note3't)et~R.'Pfibfl~E'}FEE SCHEDULE BELOl.' 1. ~~ OF I!i~TALLATIONCent ~ Oregon Utility Notific ' lQio IJN ~I::~(- errsl-800'33;p.234ij~'J ~~?!ldential-Single or Hulti-Family per d'Jelling unit. LEGAL DESCRIPTION Service Included: 1703:;.700 (/(/103 Items Cost Sum .f0~ JOB lsr;RIP1ION ".' ,_ _ , ' .. . 1000 sq. ft. or less ftJsm f ('J,{((lh[(1 FOflt. ~77!'c:Gf" UChrach addi Honal. 500 , sq. ft or portlon Permits are non-transferable and expire thereof if 'Jork is not started 'Jithin 180 days Each Manuf'd Home, or of issuance. or if 'Jork is suspended for Modular 'D'Jelling 180 days. ' Service or Feeder 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders / ~ h ,Installation, Alterations Electrical Contractor [....f(. fJ,/l-b '11m ])ve., or Relocation: , Address {pg tuE5r "0" ~ 200 amps or less 5p& / / ,r; 201 amps to 400 amps Ci ty' INGF/it...D Phone 7'17'lH3(J 401 amps to 600 amps 601 amps to 1000 amps Supervisor License Number / 'f 73 S Over 1000 amps/vol ts '0' //11/"1 Reconnect Only Ey.pi ra t ion Da te II (1/ C/ Constr Contr. Number 0%619 !2//i I ()O $ 85.00 $ 15.00 ,$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40_00 C_ Temporary Services or Feeders Installation, Alteration 'or Relocation Expiration Date 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Signature of Supervising Electrician y~, ~.J~U-.- - ./ O'Jner~ Name m.6.'S . r . Address 7'-1-1 tll/mL llvE4/lutr Ci ty [:t1Ql3I11G' Phone fcJ9.. 220 , Cf 7 WJ if C:r/f.E(;, OIINER INSTALLATION 'S.hefhts h/1.tqh- The installation is being made on E. property I O'JO 'Jhich is not intended for sale, lease or rent. D. Branch Circuits volts $ 40_00 $ 55.00 $ 80.00 see liB" above' .' Ne'J, Alteration or Extension Per Panel One Circuit Each Additional Circuit or 'Jith Service or Feeder Permit ( $ 35.00 35, $ 2.00, not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm Owners Signature: ------~-------f--r.--------------------- DATE: S/J/q~ ' RECEIPT #: ' . .fl1 U jj~} RECEIVED BY: Iff' {.oJ 11".,'1 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL . ' .... . 40.00 40.00 20.00 36.00 $ $ $ $ ,3S,- 1,7i:; 1,0 C; ~? k>0 -, ,