HomeMy WebLinkAboutPermit Electrical 1994-3-2 (2)
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SPRINGFIELD
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, \\tad ha$ the follow\
, 'led as Gubm if lend use
'the io\lowing pro not require spec ,e
. and does
225 FIFTH STREET zonmg, \ ELECTRICAL PERIIIT APPLICATION
SPRINGFIELD, OREGON 974"ft,ove. J.....1l0 ~ n/l r-..\ I Lo
INSPEctION REQUEST: 726_3769oning~ 'City Job Number '-1.-n J \
OFFICa: 726-3759 . (.,.t.~'-:/-~ 3
' .' \ffi rn\lpu,r. nE SCHEDULE BELOII
1. LQ.!;4T;l:Q!i OF GEN$TALLA;1'l'ONzcd s.,gnnture_ .,
~ ,,-_~':::") \..)\ l...rf'Ifl\ ~ A. Ne~ Residential-Single or
Multi-Family per d~elling unit.
Service Included:
)1B3~~~ONonl~L:
JqI!..D,ltSCRIl1t.ION Q 0- 1000 sq.ft. or less
\..M.DH\l'O ,~J.l.\1')* f\1>.U.~ ,tJ\.~ ~Each additional 500
~ sq. ft or portion
Permi ts are non-transferable and .expire thereof
if vork is not started vithin 180 days Each Manuf'd Home or
of issuance or if ~ork is suspended for Modular D~elling
lBO days. Service or Feeder
!
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
,
Electrical Contractor
ROSE CORP
B. Services or Feeders
Installation, Alterations
or Relocation:
2. CONTRACfOR INSTALLATION ONLY
. City
"Wif]l "
Phone IiRIi-nqn~
200 amps or less ~
20l amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
'$130.00
$300.00
$ 40.00
SJ
Address
89976 DAY LANE
Supervisor License Number -156RS
Expiration Date
lO/l/95
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Constr Contr. Number
..
5443 i :"
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Exptration Date
qnn/q~
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or lOOO volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
Signatur~ervising Electrician
. (/~A"//~
O~ers Name \\Q ~'ti., \=\.fi * 0 Q \
Address_ ~~ ~ S \Jwffl f>
City ~()l. Phone
OVNER \ IMTALLATION
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addi tional
Circuit or ~ith Service
or Feeder Permi t d $ 2.00 4
The. installation is being made on
property I o~n vhich is not intended
for sale, lease' or rent.
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
-----------n----~------
DATE: t7 ~...<:..,q ~
RECEIPT t: t&t<f (} \. \ '6 t;;,/
RECEIVED BY. . ) "
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
cO
54,
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...c:::,ID/ln
Ovners Signature: