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HomeMy WebLinkAboutPermit Electrical 1997-10-10 (2) '1 [. lIIIII-- . ------ Zoning-\y)cl y Oatel [}- J () - <17 ~()~*- ~ - 225 FIrlifhSmEfinature rJ ~ "'~<<, {:> ~LECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ~~ # (\~ r./ a INSPECTION REQUEST: 726-3769 .B.~ ~t/f ~$:) <(City Job Number "7 j / /57 OFFICE: 726-3759 <<,-r-.~ ~"V ~ 1Y ~LETE FEE SCHEDULE BELOII 1. LOCATION OF INSTALWION ~. ~ <::,~ ~<<,((:. ~'f- ~/'::?6 .-c;;,r<;,(~A;A~~{J .n,'*' ~-0~ f0-1p. ~ew ~esid7ntial-single.or (/ - ~v <?V ~<<,v 0 if)\1!ul tl-Famlly per dwelhng uni t. LEGAL DESCRIPTION "'~<::, ~()<(' ~v~ ~<<,<(' Service Included: \{:\ .'<<""",,~ Items Cost Sum r ~'- r;;:;v JOB DESCj.IPTION va.s\ ,'8 IUu~ -AouS c:- ~~ uA-"'rV v Permi ts are non-transferab.le .and expire if work is not started within 180 days . of issuance or if work is suspended for 180 days. 2. CONTRACfOR INSTALLATION ONLY .B. Electrical Contractor.1f\'~\1~j~~ Address PD. &'l. 1~3.;l3 Ci ty go l~ V'n ,Phone .fx:2.,-/1R/i-J./8'1Q Supervisor License Number 2:{ :?,,? -;0,_ Expiration Date J()-I -qg Constr Contr. Number ()~o5q3 1000 sq.ft. or less ) $ 85.00 Each additional 500 sq. ft or portion / thereof $ 15.00 Each Hanuf'd Home. or HodularDllelling 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date ;;'-/~-qq Signature of Supervising Electrician ~L~#c?2A6/ Owners Name~' \1"HD\"vu~ ~ Address 'RCI s. ~ciflc fhJ.llA LB.() rsnx LJSl '--' City YV11ll'1vuau:1-h Phone .t:)()?-,-R~'iS-OOCjIo OYNER INSTALLATION The.installation is being made on property I own which is not intended for sale, lease or rent, Ovners Signature: --------------------------------------- DATE: Ib -/0 - '7 7 RECEIPT 11: ;}7&4- '7 b"~"T,,,.,n tJv. K'w 200 amps'.crr less. 201 amps to 400 amps Over 401 to 600 amps . Over 600.amps or 1000. volts D. Branch Circui ts $ 40.00 $ 55.00 $ 80.00 see.~ uBu above " New, Alteration or Extension Per Panel One Circu1 t Each Addi tional Circuit or with Service or Feeder Permit S 35.00 $ 2.00 no t included) Miscellaneous (Service/feeder -Each installation . Pump or i rriga t ion. Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee 'I'O'l'A1. $ 40.00 $ 40.00 $ 20.00 S 36.00 /42l?a.I .,>_{?d .~ nO /c.?$'~OCL