HomeMy WebLinkAboutPermit Electrical 1999-9-15 (2)
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225 FIFTlI STREET ELECTRICAL PERHIT APPUCATION
SPRINGFIELD, OREGON 97477 Ciu OtJ
INSPECTION ~aUF.ST: 726-3769 City Job Number 71 I!> ~I
OFFICE: 726-3759
1. ~l'IlO OF re~ION
.....rl->'" \1\.)1 l-:rJ
LEGAL, DESCRIPTION. WI' Y
k\ I~I'-. v'l.:1h;l;7w~l9r8r~iiI';'''h
fo\toW fU'''''.... ",,-' 1 hOc'" rUlef i11r; ";'-" - 1
Notificetior. ce5on. .DE~C" .~ION,A 952-0(J -
. QrV.I,)" ' . - -,=-J~,,,,-,.,,,
in OAR 952-.J f-f!!' f , _ :.nC ~.IV~
OORO you may UlJ'~'" --'"'I\1et3Ieprol~iV
. ilinc.P.~.x:.mi,t:;'.E'ar'~'i\?~:;,~6~!'8\;~!;<ble and expire
ca "f~),:',9.~k:ji(sJ~'o~JI~,t~r.tc~. ~i thin 1.80 dilYS
numbeof issuance' or~,f vork' is suspended for
...... . .,
180 days.
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2. CONTRACTOR INSTALLATION ONLY
Add,ess '(? -'
Ci ty 3iAo.Uw___ PhoneJO~ Rr</dJ/
supe~ense Number d, 1.,Q, ~
Expira~ion Date~l }qq
Constr Contr. N-::;::raO-/7C?~ C.
Expiration Date 10/DI/c;Q
. I I
Signa~_Of~iSin& Electrician .
'---V. .A,IA-'1T/iIf(IJ PII.JLJOC;-
O\lncr~ Name Y4-7'/aUA-1 D.
Address t: d, 8lJ~ II $ 2- 8
City EFU~(i}Vt:i PhoM tf1'1Yu
OWNER INSTALLAT~ON
The inst.:lll<ltion is being made on
prop~Lty I QVn tlhich is not intended
for sale, lease or rent.
Owners Signature:
~~~-~~J-S::-~-------------------
RECEIl"t ,: / 15~&.rJ"
RECEIVED 8 Y :l::J..Jn.a Ih tLd ~
3 _ COMPI.ETE t'EE SCHEDULE 8ELOII
A_ Ne~ Residential-Single o.
Hulti-Family per dvelling unit.
seNtff,e:1:~uded: ~1"~\F'Tl-lSWORK Sum
;&1-115 PERMIT 51-1/1.LL E 11-115 PE~ti! 15 NOT
~~~~m~1~~~BANDONEDF"8g -
sq C<3IlJ\MiN{i'4iU l-8n
there$~MnAYPERIOD~ $ 15.00
EacIANanll't"'lI'llome. or
Hodula,'Ovelling
Se.vice or Feeder S 40.00
B. Services or Feeders
Installation, Alterations
t" 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 -----
S 50.00
$ 60.00
5100.00
$130.00
5300.00
$ 40.00
Temporary Services or Feeders
Instal.lation. Alteration or Relocation
200 amps"oT less
201 amps to 400 amps -----
Over 401 to 600 amps -----
Over 600 amps or 1000-vorts
$ 40.00
S 55.00
S 80.00
see na"
above
Sranch Circuits
.'
Nev, Alteration or Extension Pcr .Panel
One Circuit
Each Additional
Circuit or vith Service
Or Feeder Permit
5 35.00
S- T. 00
E.
Miscellaneous (Service/tecder
-Each installation
?u~p or irrigation
Sign/Outline Lighting-
Limited Energy/Res
Limited Energy/Comm
not included)
S /.0.00
$ 40.00
S 20.00
/. S 36.00 ~
3(",.uv
,;;>... 'S 0-
/-~
,:<, q., (/Jc,J
5_ _ S\JllTOTAL OF ABOV];
~ Stale Surcharge
3% Admini~trative Fee
TOTAL