HomeMy WebLinkAboutPermit Electrical 1999-3-30
Mar-22-99 04:0SP
.
P.03
.
~"f1INGIFIELD
T~8 fOl/owlng
lonln project es submlll
8Ppro~~fnd does nor require s ep~~~S t/~e fOl/owlng
. lIe and use
ZOning. ELECTRICAL PERIIIT APPLICATION
974770ata - ~ - 3,.> -"f 91/1 U., .
7Z6 _"I.f.o . . f' t J b N b 1/ 1 <-Q
......llO(izeo Signature ,:. u: 0 um cr
-
3. COMf~~EE SCllEDULE BELOY
110(')0
~''''''i'ICE'
,.]OB DESCRIPTION .. . 1000 sq.f.t. or less
4/AJl-1"l f'",<i''' Y'- '.' ; "C:R~~IT SHALL EXPIJlE~"T/lIm1NOON'al 500
/ ~t .
, .., q':-r:n.l'~' n H (, o. onlon
Pel'ffilts arc non-transferable andexPlre.DE.T, ISt~~ fSNv~
if 'Jork is not starred 'Jithin 180'days~-" .Ai~~aJ!)j.f/d Home 01-
of issuance or if 'Jork is s,'i,Win6t~lW;FllglJ, Modu~arO'Jelling
180 days. 9 G SerVlce or Feeder
2. CONTRACTOR INSTALI~TION ONLY B. Services or Feeners
I Installation, Alterations
Electrical contraccorjjl :u-~UV\ ~ or Relocation:
Address IO'7J\) ~\ l\ ?,x>d. ~1.- 200 amps or less $ 50.00
(L I t... / I I v1 201 amps to 400 amps $ 60.00
Citd.~f.vM. I~ Phone'/5"-1-/0~1 401 amps to 600 amps S100.00
rvt_q n D'-- 601 ;;imps to 1000 amps $130.00
Supervisor License Number <IV L.LA-: Over- 1000 amps/volts 5300.00
q Reconnect Only 5 40.00
Expha.ion Date //)- /- q
1Yf_ # C. l'emporal'y Services or Feeders
Constr Contr. Number :S,~ Lj OU Installation, f,lteration or Relocation
t:: )1 C(- () (9 M' I t:NTION:Oregon law requires you to
Expiration Date C-J - Ul..:..l follow~ulesMeplimjl/s}i'~())~nUtiiit" $ 40.00
I~ollflcatlon C1HHer; IjjMs~RJIl!9\olr.?~BH(';'h $ 55.00
Signatur~ of Supervising Electrid"ninOAR952.001l-<<>1eG~rot!?lh~RR~1 $ 80.00
fA0. l......Ji _ \ 0090. You m~lAAa!i990i511!!l/'6fffie n.\-ISS'byOltS see "B" above
L ~ ... ~>>:\\~..v...D calling the center. (NoJe: the telephone
}oJ I / .r'" / numb41 for tM'!!.wJgo~,'t5fi1H~ NOtification
Ollnel's Name UO#,lrfd 1;"0.,;.,/0/1- Center is 1-800-332-2344)
I Ne'J. Alteratlon o. Extension Per Panel
Address 72. Lf e,Il(J/L /h II ItJe
Ci ty S;Jn.d~f (;h/(/ Phone 7'1t,. '/0/
OIlNER INSTALI~TION
225 nnll STREB'!,
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTAL~TION
721/ ffl/t:ltJ.l,(/
LEGAL DESCRIPTION
17~3J'1f 7-
The installation is being made on
property I o'Jn which is not intended
for sale, lease or rent.
Ovners Signa ture:
-------- - --f -:.. -h --- - - - --- ---- --- - - ---- ---
DATE: 5 j]'fl 9'i
RECEIPT #:' I I! :Jj:f>JI'f
RECEIVED BY: N 1;) ,
A.
Nell Residential-Single or
Multi-Family per d'Jelling
Service Included:
uni t.
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
-'
One;Ci.cuit
Each' Add it i onal
Circuit or with Service
or Peed'll' P'lrmit
$ 35.00
$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation S 40.00
Sign/Outline Lighting S 40.00
Limi ted Energy/Res ; S 20.00 7..-"
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL
2..~ . (flj
/. cJ 0
,(,.0
2/.(,,0