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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