Loading...
HomeMy WebLinkAboutPermit Electrical 2000-9-1 ~-Af ~~ 225 FIFTH STREET ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 . . sthefollowing / INSPECTION REQUEST: 72'~~lM'ingtOlect ~~:~~i:ttsepde~~iC land ustCi ty Job Number 00 -0 (s s'-f - 0 OFFICE: 726-3759 zonlOg, and oes no approval. ~ -.A . ~~~ 3. rOMDTvr~.PEE SCHEDULE BELOV 1. LOCATION OF INST~LLATION zo~mg 4"... I .. ~@ _ 3(0(7 AVVlble.-s it1~te D,-'ve ~. New Residential-Single or Authorized Signature Iluld-ramily per dwelling uni t. Service Included: LEGAL DESCRIPTION ! 70'L3e>ba oo6:f::) I Items Cost Sum 1000 sq.ft. or less $ 85.00 g~4()O Each additional 500 sq. ft or portion I-l foOr 00 thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 JOB DESCRIPTION WVtOI-e Vl0USe W~(' ('V! r Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Services or Feeders Installation, Alterations or Relocation: B. Electrical Contractor!-,ft: E(t:'L-t('t c Address rpO Box (0g to Ci ty-.&LLb ()J1J-4-!hone,)Cf/-1fp7. ~fo7.. 7 Supervisor Licensecttimber::Jq ~ 5 Expiration Date / (j - I - 0 1 .Constr Contr. Number. 5 Cj Lr Co g 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 . Temporary Services or Feeders Installation, Alteration or Relocation C. /() -/-01 Expiration Date 200 amps or.less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 $ 55.00 '$ 80.00 volts see "B" Signature of Supervising Electrician X~ ~(LLQ. Owners Name 2t vc-rL J M~ {(A-: (~'" D. I . - .. 2-0'-f ( Phone 72b "-0"330 above Branch Circuits New, Alteration or Extension Per Panel Address ~ ~ 9< Ci tG(LV A--( V S One Ci.rcui t Each Additional Circuit or with Service or Feeder Permit $ 35.00 OVNER INSTALLATION $ 2.00 The installation is being made on property I own which is not intended for sale, lease or rent. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. not included) $40.00 $ 40.00 D $ 20.00 ~ -i $ 36.00 ;u:i5$ n-; : z: c-J JTI (.1') 5. JUBTOTAL OF ABOVE /'-15 \~ rI; ~ ~ 7'% S ta te Surcharge, I fh.~- ~ '"TJ ~ TOTAL 3~ C{~ F-U LI .~~~g 7ift~ /s~~ag~ r- .. '-' <:..J ".) Owners Signature: --------------------------------------- 090100. "'30'12 'D~ DATE: RECEIPT #: RECEIVED BY: