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HomeMy WebLinkAboutPermit Electrical 1999-12-29 (2) .' ~'.,.\ I.-JUC - ~.o: ~~G~;[{~; \ ';',i ,~. :HJ:JTAu it ,~t~ (.~ S: l1~<~:51 t 11i-'; ~ ~Ii;~h.! (\\":,~'2?5"FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 The, following projecf as submitted has the following zonmg, and does not require specific land use approval. Zoning /... LA I Date I.;;> ~':)<7 - cr q 'll.,ECTRICAL PERMIT APPLICATION 974AJthonzed Signature i\~ q <1' J!-, /1 ? 726-3769 ,,~ty Job Number II //d /tY 1. LOCATION OF, INSTALLA!;2l'l/A .. I b/ J 2 tf f1(trAN//N I - LEGAL DESCRIPTION /1(J~ '!,4-4,/ /'JJ9@ JOB DESCRIPTION fIU7f...K' r'l;2CI/I r Permits are non-transferable and expire if york is not started yithin 180 days of issuance or if york is suspended for 180 days. ' 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor 4'1frI~ aJ ~rI/C r . City RoY IEI/6l.1.1t.- 23/51/ Address Expiration Date Phone 3'/'I-'I'l:Z-r' ~393- .s /,1- / -uJ ~''f7 j'!1 t?f'- fJ I Supervisor License Number Constr Contr. Number Expiration Date Oyners Name Address City Phone 7f7-g?Q OVNER INSTALLATION The installation is being made on property I oY~ yhich is not intended for sale, lease or rent. Owners Signature: ------------------0- --~~------------- DATE: /"2- 2-'Jr J!'i RECEIPT II:' 17_1 RECEIVED BY: ~J~~r 3. COMPLETE FEE'SCHEDULE BELOY A. Ney Residential-Single or Multi-Family per dyelling unit. Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or ~ortion thereof Each Manuf'd Home, or Modular 'Dyelling Service or Feeder B. 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 Items Cos t 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' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 see~"B" above .' New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit I Each Additional Circuit or with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 35.00 36,0::> $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~-rS-60 z...1'J /. /J,T ? B :)(l ,~ , _.- , , . TRANS#:01-0000121 ' DATE:DEC 29 1999 AMT RECD:2 $ 38.50 CHANGE: CASHIER: 003 '.