HomeMy WebLinkAboutPermit Electrical 1997-9-19 (2)
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~~~~~~~i~~g~~j~~\ ~:;~~:.iltad n~~fa~. followi -.
225 FIPTH STREET approval. pee d U"ELECTRICAL PERMIT ~LICATION
SPRINGFIELD, OREGON 97477 Zoning LV l () rAn
INSPECTION REQUEST: 726-3769"1 I Cj . Ci ty Job Number 10 IVI
OFFICE: 726-3759 Dat. '-1 ~ - t(1 ....... .
Authorized Signatu' JJ ~. COMPLETE PEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION J ........ re AI
~(50 tJ.A-rt:::iUJA'-I IJI,JVP A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
J~ 03 'Z-'Z- "2tJ (J~'-IOO
.
JOB DESCRIPTION .1 1000 sq.ft. or less
--1u/)Ill~ ~P- GtEVArtO/ll Each additional 500
(!.HA-AJAJt8L L.t::.11t::ILS sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within Wp. days Each Manuf'd Home or
of issuance or if work is sus~en"J,1~r Modular Dwelling
180 days, J.(IS PI:. : Service or Feeder
~!Ill lY).flr
2. CONTRACTOR INSTALLATIONCb~~ORI.?1:. SH"tt: Services or Feeders
'41).fiitl,,^_ ~l){jN{) E'XP;~tallation, Alterations
Electrical Contractor GS~~.b,.. ~RrH.oi'C:W~cation:
(JDAv^ v/"fIS rspf:, ~WO
Address ':7--1 () O/tfLP/t'f7!.H Ki::i"$Q/('I "S"NA,Q9R~Ilk- ofRlress
~ . v{) ~eIJ:R~"'\6]'400 amps
Ci ty {;i. c.l~e- Phone 'I'il5 --5Si.f(,; 401 afnp'~ to 600 amps
L17r-- 601 amps to 1000 amps
Supervisor License Number ~J Over 1000 amps/volts
Reconnect Only
/0 -/-99
Expiration Date
C.
;Jo-7~~J C'
Constr Contr, Number /II~~"
Expiration Date "1~;J--ge
/() -/-91
Signature of Supervising Electrician
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e-n/-;{;; ~
Address '3J.:iV ~-4(/ ~
~. /
City :3J1/Z~GtJhone ?::;.b -69//
Owners Name
OIINER INSTALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~=---------~~\-CXft\----~---~ 5_
RECEIPT jI: ",\,'l,l f\
RECEIVED BY: ~i1r-' ti- ~
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100,00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Ou tline Ligh ting-L
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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