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HomeMy WebLinkAboutPermit Electrical 1999-9-29 r; ~, \ /j'6t.I'; The following project as submitted has the following zoning, and does not require specific land use 225 FIFTH STREET approval. ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 Zoning LO Yl- . ...' . q q 1\ S ! --I INSPECTION REQUEST: 76R-3769 q-~"1- ~q Ci ty Job Number, U ' '. OFFICE: 726-3759 a e -_ ,; l Authorized Signature ~ 1. rOMPT .F.'T'E FEE SCHEDULE BELO'il 1. LOCATION OF INSTALLATION ~:2- 3' If S'/ICee-) J LFftft~?J(I~~ (JJ.5 0 c; JOB PESCRIPTIO N\i O~ 30 13 00309'~' . " sq. ft. or less <)~CC-Lu?/~ !j/S'/~ , 'l'l/Loa ~~itional.500 ( -4J, ~~~ or portIon Permits are non-transferable and expire v"'~e~~~. if work is not started within 180 days C04?~)!~~~Q ~~me, or of issuance' or if work is suspended for ,qiVy ~~A~~~ 180 days. 180he~ YAA~f?'dt8:tf:h. . $ 40.00 ~YA IS~ '1SA 'I"f~ 2. CONTRACTOR INSTALLATION ONLY , B. servi~er~~A~~ WO"<;>>k' AP_ (' InstallatIon, A~~~t~ Electrical Contractor~/AH/ ~~~/'J-~or Relocation: 0,.<;>>'" . . Address.' /(; 9'0 f-;.o/fJ #/f/?"'"' #eV / 200 amp.,s 'or less $ 50.00 . 201 am'p';s~)",~b 400 amps $ 60.00 Ci ty R7/~?: CP1~ Phone~I/~-?t26f- 40~""~~P~~;~Q/{c~.QO. amps $100.00 . , 60{? amp's .to -rooo amps $130.00 Supervisor License Number "i5( IT CJG s- ov~,f~'/19r?~~if~~~\j\q~ts" . $300.00 ,.~ a 1\~7~Hi,i}ec-t?;o,n'~y:,,~~,. ';.O'O/"'i'M $ 40.00 Expiration Date /C/ ..- / - f ,7 170. ',91/, Iqtl' Vi"' "1 YI:) C'f(j 6\1" '9 '//0"" v fr:: ',..,C'>~ . 'i'i 5'" .1....,1, C. Tempora.ry,qSenl'ices" '6b:- FeedEfrs. Ins tallit~j,on9t !(lzt-~~'la:t::i();h 2tJl:~~1:oca tion """ \./~, . I/!I ')().' ->F10' ",'I". '(,1". Ie. . '(if"",o,. Fe." 'Xf. ;9 05) ,'I,:, 200 amps"oT';X?s'i,:;'j'l;~orIAf9'9.S~<S'Sf~4fJ. 00 201 amps to 40,Qx~~~F~ ~l&j",,\;'i(~l ~$D55. 00 ' Over 401 to 600"'ap1p~bJ'.JV-?'~s.,&.s'S lao.oo Over 600 amps or r6~0-'\iQ.n~s ~~e "B" above . . 1/01) . . , .. A. Constr Contr. Number /tJCJ '1 ~ / , Expiration Date ,tP /~CJ/:; a 'rt:Signature~E1ectrician. . vr~ _ fi'~CJ-I'>{g7C1rt---n. wners Name / .O'~~7:ttLlL&-r4 Address ,') 3v ,~( S't-Srr ~ Ci tyStr/IlCI.,..i.dJd ~ "Phone ?/..t~tJ)'J b OWER. Ir@~~TION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~ r I , DATg~--~t~zr-t~~---------------~ RECEIPT #: ' , " RECEIVED BY: 'I . tlJll I A ~ New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum $ 85.00 $ 15.00 / Branch Circuits ,. New, Alteration or Extension Per Panel One Circuit Each Addi tional Circuit or with Service or Feeder-Permit, $ 35.00 $ 2 . 00 . E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res / $20.00 ~iJ..J'" Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 7% State Sur9harge 3% Administrative Fee TOTAL :1P-fcf I (jJ c,/ LL I () ('J