HomeMy WebLinkAboutPermit Electrical 2002-5-30
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The tollowing project as submitted h~.S the following T[:;I,}.IC'tf. ril-'OfiOClI'JCI'"
225 FIFTII STREET .' and does not require specIfic land mCTRICAL PERMIT APPLICATIO' :;:.,I''ll..iit. v I \J .f!~.f (
zoning, \l}1TE' '1^\! ~fi ,.,oor,
SPRINGFIELD, OREGON 974jbjbroval : liH I .' I Hi ,..J1j L L
INSPECTION REQUEST: 726-3769 Zoning r;of'2-..- 2iLJ ;Ju :t';-umo'ern =< () () ( 11. ~.qlbr;;ElCD: 2 ! 57. 5?
OFFICE: 726-3759 5- '10'--0 ~ . - I. LHANGE;
Dale, r>AC'UTCC!, ntl1
, . .' '~ll ~mvlPLETE FEE S(.:HEDULE BELOW LJ wi IJ.LI\"J_J.
1. LOCATION OF INSTALLA:H(9f\fed Signature . .
/ f!1 f 1"/ t;r~ ct:;-] A New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
,~.CE: {MI~~HAlL EXPIRE'lF THE V$~
lW ~j. ~R 'tHIS PERMlIJS$tIIDIo
MAlt-! ~ ~ Wk~RANDONE!'} ~fJROO.OO
OOMtB\i~~ 11J~ iris see '
. ----.-"l\fWl(filrD~PER10 '.- '_d
LEGAL DESCRIPTION
aT") '5 .~ (orJ ~ L1V (\, 0
JOB,>>ESC;RIPTION .
IC-e.t7{tic-< JbevK~ jJIlA'sr.., 1lAerr:....e..
, 1000 sq. ft. or less
Each additional 500
sq. ft or portion ,
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations or
Electrical Contractor 1'fIo if, j!) I ~ t2t 'c;, iii J?-c.-r Relocation: .
Address 4t'3> S... al.~ (,.T
Citv..~._?!?(;;J'!,:; "'~"'" .:\ehQne,;:..jr.g;}.r.:,q~l(" ,
. AI "_1 '. '1'-:' 'd~'pt~d by'the Oregon Utility'
~8~Ip~I~r 'Dc~n~~N~~~ ~1<i1~Q'~set forth
NotltlcaIlon vel" ,. ~ 'OAR 952-0C)"I-
. ~~R952-001-oo1OthrOUgn .
IE , 1 atlon nate, "l-~i/' ,~J.i':iM of the rules by
00 . youTm:-"j -_..: r
llina the center. (Note: the tel~pho~e
Coti~ hContrr Nnmvber.., nnrll lttS ~[.Gtcatlon
numuenD ure", 1<:'... ,"~"
. . Cpnteris 1-}300-~32-2344).
ExprratIon Bate (&,r- r'.- 0.5:'
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
60 1 amps to 1000 amps
Over lOOO amps/volts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signature of Supervising Electrician
, '_ 1/ . /I " .
,:x!7~(~ ...JZ,
...._._.._=--\.1, _ _ -, . _ .. " , . _ .___..D..Branch..Circuit<;
Owners Name r;e..,q- il/t!!../<;. /Yl (rc.ill:LL .
New, Alteration or Extension Per Panel
Address ; f ~ /
Ii 5tiZ. elE r
One Circuit
City ''[; P /'b' Phone
OWNER INSTALLATION
Each Additional Circuit or with Service
or Feeder Permit
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting:
Limited Energy/Res
Limited Energy/Comm
Owners Signature:
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
Items Cost
Sum
$106.00
$ 19.00
$ 50.00
"C
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
$43.00
$ 3.00
. $50.00
$50.00
$25.00
$45.00
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