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HomeMy WebLinkAboutPermit Electrical 1996-7-24 i::: '".,..-J ,.4., O'i 121/98 '5'503726 3689 SPFD DEV. SER. 141002 ," " ' i. t I I l , 10:55 . . 'The following project as su mea' s e> zoning, and does not req fa sp0CiTlc land u, approval. 11,' Zoning l..,C.../ 225 FIFTH STREET ' .. Dea;)/~ SPRINGFIELD, OREGON 97477 ~~Slgnature n M INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 ELECTRICAL PERMIT APPLICATION L ~ City Job Number C\ ~ () ~3 1. LOCftTION OF INSTALLATION ~-S-/Jf Q) $/ -SoR../IlX1tFieUJ. A. New Residential-Single or . /'1 03 ;).~ ;>q05503Multi-Family per dwelling unit. LEGAL DESCRIPTION F, '-<10-:, , Sel:vice Included: ' " ,. I T kE kc) ~.t\-,:) S ,IJt(l~O~i1t ~?,. Items Cos t '/'} '~. 'VI'; 10 ' . '7'") JOB DES.CRIPTION 00.9. O-<1,<y"c!;QQ (,,~.s- ~b 1000 .c;q. ft. or less r n L..E: :s l (1 n) '" ~ '- ~t~ ~ ('I c!;oo ~~ Each addi tional 500 , /'}(.I,-~~' '0(" "Oa.......,/~/O/<9 O/'}hsq. ft or portion Permi ts arB, non-transferab~ ~.d ~~y~ ;.:- )-. IYOJ.- ~Itt'!ereof if work is not started withi~Ii[?~C'!d'a~Vl'o ~~ &(~);I.anuf'd Home. or of issuance or if work is s~E!~e~~~~ ~I';) &r~~~u~~'Dwelling 180 days. ?&r:> 01'; ;':-IIV, "90( ~.9~ ~~~~&J Feeder /.s- l'. &.90 0,& ~ ~ O-i c!;r& ~. '0 2. CONTRACTOR INSTALLATION ONLY '<900. ~ ~:"1~' o~/t<>>~ e'e,s ~ Feeders i I '0>01 1'P'yl&I&I~.;~i?~n, Alterations Electrical Contractor HEA'T)-l S"i~JEl.~''Vo".&~:t~F'~,non: 1 J '~I . ~ ' ~~ "~o. o/'}& OJ.- Address 'Y~J..j'1 :s C. / 7 ' . 2~~mps or less U ; 201 a.mps to 400 amps CitYfTLD18~'i7;;()2Phonr(s-Z;3)..23:J-::;(,:>O 401 amps to 600 amps /. ~ - 601 amps to 1000 amps Supervisor License Number :;;tt,-r9f? t'iS Over 1000 amps/volts . Reconnect Only Expira tion Da te /0// /7'1f ' / / C. Temporary Services or Feeders Constr Contr~umber ~;?17~;7~ Installation, Alteration or Relocation EXPiL"at~n~~ //~ 7/0C> 200 amps"'or less $ 40.00 ~ ~ ....0 .<:' / / 201 amps to 400 amps $ 55.00 . s~~~~~~:;~~ g~:~ :g~ ~~p~o~"a~g~o volts :e:o~g? above , -: ~ '\o_4~ r D. Branch Circuits ," Owners ~m~6jL>72~ ~ /o.Y.P~ New, Alteration or Extension Per Panel Address9~~ ~~4KAtV~2S On:' ';) <!\)'~~ j Ci tylT.iZ> I O~?i.%7I'hone c28s","/7.1y- / . -& .~ ~ O\INER INSTAL~~ ~'*= ~~Q The installation i~e~~de on property I own whi c:n is ::no{ . in tended for sale, lease or rent. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting J( Limited Energy/Res Limited Energy/Camm 3 COMPLETE FEE SCHEDULEBELOY One Circuit Each Additional Circuit or with Service or Feeder Permit E. Owners Signature: ,.... DATE;----------:-~--rr~~~~~-- RECEIPT #: \~,\! ,-J..d f ) RECEIVED BY: J J \' \ ~ - \" vV---- 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL Sum $ 85.00 $ 15.00 . $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 $ 35.00 $ 2.00 $ 40.00 $ 40.00 $ 20.00 $ 36.00 '00 "/D~ 00 .D7~O ~O , ''7/3- I