HomeMy WebLinkAboutPermit Electrical 1999-9-22 (2)
The following project as submitted has the
N,.1.0ning, and does not require specific la
1..I"r~~!~, L (') R
TH/S PERM Zoning , ~
AU /TSHAII t"Q~'::l.. _,
T~/!{it:E ~~! .\:uucAL PERMIT APPLICATION
97477 COM_~~4flI/;I1iiEt'l"H: t" ~:(
726-A7# OaR/SABAN' M~NOrob Number Cf'1 D3rJ..-f
1800AYPE DO Ol=i
R/OO, 3. COMPLE'i'& FEE SCHEDULE BELOII
LOCATION OF INSTALLATION
/.ttfP<l In~0!Jh'A' fl.
LEGAL DESqIPTIOl}- .....,'\
I(,ov()1.. :J..'d-" b :::> <60 U
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
. I . Ins talla t ion, Al tera t ions
Electrical contractorf),'lnr1"1. 'tlnll""l1t-VTor Relocation:
Address fJ. tl. /{/J" '{/}~v ,200 amps or less
201 amps to 400 amps
Phone~,-vk"-().il7T 401 amps to 600 amps
601 amps to' 1000 amps
Over 1000 amps/volts
Reconnect Only
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
JOB DESCRIPTION
Si,l'-uf Cb: <;;"/~'''''/ (;/17/'./,,1 ,on""9<1
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
Ci ty
?, //(1 Nl/
Supervisor License Number
8.q~1 JLE
Expi ra t ion Da te 10 I t}CJ
Constr Contr. Nutber (j'if/1/5
Expiration Date tI 100 ___
I
A.
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
. thereof
Each Manuf'd Home, or
Modular'Dvelling
Service or Feeder
uni t.
Items
Cost
Sum
$ 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
............... 200 amps' 'OT less
~2~1 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Namek'tv';" ./omrlLArIurn IknuK
Address 2:<'7 <;;-"'n~h <-InCA P'lAn
(J One Circui t
City . ~/Jr'n9/J,id p.hone-1,J"J' '''Jt!:Li.L Each Additional
Circuit or vith Service
01lNER INSTALLATION,V17~'~'C:88'008' ~ s; ,.';.dJ or Feeder Permi t
UO!IB:J!I!ION ^I!I!1n l!o6aJO aWl ,101 JElqwnu
The ins talla t ion fi'sllbeing,l,!!ad.e'l\qntEllUEK 'U: JE;;,eOMiscellaneous (Service/ feeder no t included
property I ovp. ,i(ri..<;hJ i'1;1 r.OJ3!~I].J:<j,'.'sI.\;!! I\eu: 'loA Otiii~ach in~ ta~la t ~on
for sale, lease~gB-c.S'<PJ\;'Ou6nOJuIOlOO".I)U'GC;ti -JI;'Or.l:\mp or l~nga~lon. $
. ulJOnElS ElJe SEllnJ 3soUl j.J.uCl~J -'UljdJ'JoI'~lg~/Ou tl1ne Llgh t lng $
O\ll1ers Slgna tur~\~!I!ln u06aJO a41 iiq paidope ;CllnJ M()1I0~~m~ ted Energy/Res --L- $
Olno^ saJlnbaJMf!.; oDf'JC 'I JIj f\l3' ;\~Llml ted Energy/Comm $
.i.f). Qtl
I. to
. '1Q
'7,,[. 00
DATE: q-.);)--Oz"7
RECEI/!l' *: ,( 1 <,7")(tJ~
RECEIVED BY: ~,
D.
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80.00
see ltBll
above
.'
Nev, Alteration or Extension Per Panel
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$
2.00
40.00
40.00
20.00
36.00
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