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HomeMy WebLinkAboutPermit Electrical 4-8-17 ~\ 'f'" ;:..... , i ..- J-..., 11~~'-''''''''''~''~ orO)eet as submitted h~$ t"c k,l!, Z _, .' :)3 not require sP!,;-~;"(; lUll., """j S. 225 FIFTH STREET ...,Oili~r:, L-O~ ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 /,.J' /1 /.......2. ( "...., INSPECTION REQUEST: 726-3it69 ,t/11-:.,~ City Job Nlimber /' 'TL/ ~ OFFICE: . 726-3759 Autl'lv-.,..;,;~ ~,,;"diUr3--FtJry-- ~T~-FEE=SCBEDULE BELOV 1. LOCATION OF INSTALLATION ~ I ~"2- ~K..~\fwIA A. ?GAL DESCRIPTIO~ I ~t)2. OJ Z 2.6{)~1 ~~ f' Ji7/~-h -1-- . I . JOB DESCRIPTION S e-L-U~ \ ,'-I c:;:( s.-rr-~ ' Sum '\ New Residential-Single or Mul ti-Family per dwelling uni t. Service Included: Cost Items $ 85.00 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof , Each Manuf'd Home or Modular Dwelling Servic~ or Feeder $ 15.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ' $ 40.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders , . I Installation, Alterations Electrical contractor,!\l1\t\(}1JAL'f{~\1&\~~r Relocation: . Address 25\ \ vj, ~+t+- S.,.-; $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only City ~ ~l2..- Phone 4~C;--3S(a(a Supervisor Licen.se Number S \ () ~.t::: l \ () - \ -q ~ Constr Contr. Number '(0 '3 e~ ~ Expiration Date Temporary Services or'Feeders Installation, Alteration or Relocation C. $ 40.00 $ 55.00 $ 80.00 see "B" above 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts Expiration Date .' - . . Signature of Supervising Electrician 7Ut /h/ . ~ CJ ' Owners NC3;me M/t7Il.r<~t~ ,~_(djJ;( Address 45" /,/). 4...etJlfIy)~ -' ( Ci ty &~ Phone ~4 - d$S6d. I I D. Branch Circuits New, Alteration or Extension Per Panel $ 35.00 One Circuit Each Additional Circuit or with Service or Feeder Permit $ 2.00 OVNER INSTALLATION not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. The installation is being made on property I own which is not intended for sale, lease or rent. $ $ ~$ $ 40.00 40.00 20.00 2/'),~ 36.00 OWners Signature: 26 tuJ / au &EJ Z/, ~ c:J 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ;&")0 DATE~--------~~~:7~5?~------------- RECEIPT.: (/,~Jj-J RECEIVED BY: 7..(' ~ "'Ill FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 City: 7"/~ /t::'p;rt~r-?#'~ ~r ' Assessors Map #: /~-p< ~?-~L Tax Lot #: ~cr'O P" Owner: ..4k/;V'y/,7Lf.~-4'? ~~/"~ Address: Y"'?- W ~~~~Y Phone #:_~R~"" ~~ ~;::r. Zip:~/ Y~r ~ C (~~c.-r,.!"- of Fence:~ State: Job Location: Value Fence Permit is $5.00 M~~~ ~~/>~ ~ '"3::> cr I /~/ /:2 ~ Phone #: -=7 7:;> .... ~ Y>g ~ ~frV - _ / " , _ " City: C~~aF~e- State: .~~.. Zip: ~;;>,YC/r Construction Contractors Registration #: '"7? /~& Expires: /2. Y~"7 Y Contractor/Installer: Address: Dy signing this permit/application, I agree to call for an inspection once my fence has been constructed (726-3769). I also stated that all information on this application/permit is correct and that I was provided with the Springfield Deve/)me~de4;men ts for fence standards 0' 'V~~ -8-)9-74 ~)'ature Date t/ FOR OFFICE USE Date of Application: .zt -/~-'5r I Y3'$ :> , ,- r Issued By: JOB #: 0 7'~ =<?s- ~~--c. ~ - Receipt # Checked for DelinQuen~ies: 4:'" Gl .:7 '-' ", ----- Checked for Historicc'll, Sta tus: - Total Amount Collected: