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HomeMy WebLinkAboutPermit Electrical 7-8-22 The'" ' . fO!,OVJlila r::.'r~'~ . ' :Or:in1 (;r'(':~ .l.,;S CUbmli~( d ;. -) ~;~ - -,. ,. . e."l"'r~":/~,: I ~ ); 'l';Jlirr(Ai)'J,.;;;c", ,~, '; " '" ,'1[;;" ,1-' ,..., /J /-(i7"'" ....,'.... Z.. K /)- onirogJ , 971ai- ,..._~ tV..... ' . 7.2:6:.:-Bm,6!jr:ature 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. ,LOCATION OF ~NSTALLAT~O~ qr//?lS ,~..J..-~W ~/~ S7: A. 'c:7 \~O~Wm>>r //7 ~-~ri\ D\\Wi9t (Q~' ,,' per~ar~ non-transfera~lean expire if vork is not started vithin 1 0 days .. of issuance or if work is suspended rr 180 days. ~O~ ~ 2. CONTRACTOR INSTALLATION ~~~ ~ ~ ~O ,B. ~<<: ~~<<-~:.. <<9~~ Electrical contractor~~~ Address PD. ,{b"i,... e..~~;~: ~,>\j ; . ~(ji'~ ~,,- ~W~ ~ ' City go. u.~~ r{>('<<-~A~~~O~~~ ...l)8E-J48~q ,~~v~~' Supervisor L~~~ t~~~<i)2:l ;<,~-;~ ~~~~~ Expiration Date r}5 J.~I -Q8' ~' C. Constr Contr. Number_OSOSQ3 Expiration Date ,~-I&,-qq Signature of Supervising Electrician ,~ hB~-- Owners Name.-:L O(ks~f.K' ,tloMhS.. ~ Address I eq S.. r6.c.ih'c.. I-h,.o3 / PI), 'i2Jm LlSl Ci ty YVlonVYlnlJi-h Phone 5t6-~~%-OOCjfo OYNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: ------------------------fr , ~ - - --- DATE: /l ~ ,rr IlJJ G\ \ RECEIPT #: ~\ \t'A:J~ ~ . ~ _ - \ RECEIVED BY: V - ~ \~ ELECTRICAL PERMIT APPLICATION City Job Number C\'\ \\~\ 3. COMPLEtE FEE SCHEDULE BELOY New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq. ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof S 15.00 Each Manuf'd Home. or Modular 'Dwelling Service or Feeder $ 40.00 Services or Feeders Installation, Alterations or Relocation: 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 S 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 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 $ 40.00 $ 55.00 $ 80.00 see,tlB" above D. Branch Circuits ,. New, Alteration or Extension Per Panel One Circuit Each Addi tional Circuit or vith Service or Feeder Permit S 35.00 $ 2.00 E. Miscellaneous (Service/feeder -Each installation - Pump or irrigation' Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. $ 40.00 $ 40.00 $ 20.00 S 36.00 ~c:;.o' ..;,L CA./ / ,?-V c.,/ --;>~ .:2.0 SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL