HomeMy WebLinkAboutPermit Electrical 1999-1-4 (2)
Nov-09-9S 09:50A
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The fOJ/owing project as s .
Zoning, and does not requbmllled has the 'O/jowing .
approval. Ulre Specific land
225 FIFrB STREET L.~.n ELEI!iirCAL PERMIT APPUCATION
SPRINGFIELD, OREGON 97477 ZOning~r<-- I'/c.rl rJ'l r../
INSPECTION UQURST: 726-!PlI69 /- '1.- 'i e-I~ 'J Jy:' NUlIlber '1 (JU 7.:J'l ;r
OFFICE: 726-3759. _
Authorized Signature _3. COMPI.ETE r'J::~~HEDULE BELOII
1. ~:J,ON 0)' INSTALLATI.ON-- /)
!.5.S.~'::> ~./ l71.>..rYl r~ New Residential-Single 0" 'outo
Xul t i-~'ami,l..YTgW,'TI<bI..JG~olllli'(l.reqUlres Y ..
LEGAL DESCRIPTION Serv i ce In~l uoea ies a~,pted by the Oregon Utility h
/7 D5 d.,)..." 000096/ follow ru 1l~1Ilfu seGWs are !S\l~ort
~ Notification Cen . 0 hOAR 952-001-
. t"Illl1J1 P.JR;CRU'TION /J. 1000 sq. fit OAlB 9feH101-001? th~~~sQ\l t~S by
(/7!!)7t"'~' C.fJ?.(L~T ' . ~~ Ea.ch addm.~a'iOI5GOayuu'Q"ICote.thetelephOne
THI::;t't:nlvllI''''''~~~'' ..' ~. . sq. ft or egi\"I~~ecenter.(N 'Tt>~Notification
Per\'!fIW'K'1-r!\:Zf!l3t~)NL~!'.s1)j,<!:(a5re1M'ndl~d~;fre thereof I berforthe OreQO$,ljlli.1w .
if vorlc. is not started vi.thinr180r,dal'S Each Hanuf"cI !1j\ome>&rI1eris 1_800.332-234-.). .
of i'S'suanc,G'OlO (i'f.I(;d';RAW\~'usP'e\,\{~a for Modular Dvelling
l80~1f{~~~1 PAY PFRIOfl. Service or Feeder S 4'0.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation. Alterations
Electrical Contractor or Relocation:
'~'"
Address l:9.q~ ~ oj)~U}O. 200 amps or less S 50.00
~ I 201 amps to 400 amps ----- S 60.00
Citl'''''OAQPM.O..... Phone 0"Rf"/o-tO) 401 amps to 600 amps --L- SlOO.OO ~
~ r) n /(9 (l 601 amps to 1000 amps $130.00
Supervisor License Number ~ fL- < Over 1000 amps/volts ----- S300.00
~ Reconnect Only ----- S 40.00
Expit"a~ion Date tOil
C. Temporary Services or Feeders
Conser Contr. Nunlber~ - /? Installation, Alteration or Relocation
Expiration Date I of Of /q q 200 amps"oT less $ 40.00
, I 201 a.mps to 400 amps - S 55.00
Signature of Supervisin~ Electrician Over 401 to 600 amps ----- S 80.00
~"-. ~0' Over 600 amps or 100ll voLts see "B" above
. ~ "',,-., - II),.L A D. Branch Circui ts
Ovncrs Nam ,~tv...r"lJ;>OI. (u 11. l"~: f'/. "
j '"""/ '..,- Nev, Alteration or Extension Per .Panel
Address l..)V m Q.LK 3
Citl'~.LQcL-- Phone 7J...CtJ ~~
01lNE~ ~NSTALl.ATIO/l
One Circuit
Each Additional
Circuit or ~ith Servi>B
or Feeder Permit ~
S 35.00
$- To 00
, UO
.~
The install.1tiun is being mada on
prop~rty I oyo ~hich is not intended
for sale, Jcase or rent.
F.. Miscellaneous (Service/teeder not included)
-Each installation
?u~p or irrigation S 40.00
Sign/Outline Lighting----- S 40.00
Limited Energy/Res ----- S 20.00
Li~ited Energy/Comm ~ S 36.00
5_ SUBTOTAL OF AnOV!:: / / 0 . cTD
5% Stale Surcharge ,"). .,>n
37. Admini:;crative Pee .-:i.JO
TOTAL -LJ 'x - -:l1L
Owners Signature:
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DATE:!-- ~ 7
RECEIPT ,: D:S::2 <-f~-~
RECEIVED B"t~ ra (I' tJ,./L..O