HomeMy WebLinkAboutPermit Electrical 2000-8-22
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, wing prOject 8S S b '
zoning, and does not reqU ,mIffed has the folio
approval. : ,we specific land USE!
Zdning Lbif.-
Date '0 - dd.. - tTD
Authorized Signature ~
97477 '- "M
726-3769
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION OF INSTALLATION
;S If It #11111 L~ s tl)f.
LEGAL DESCRIPTION
I-:}Qd.- )qL\~
\ Li600
JOB DESCRIPTION '
au:-WiA€ .,6.LA~M. ~,<f' A(,(AA. f3 f?-OIL VACl:((.(11(
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 B.
Electrical Contractor ?Ro~~CUAU'fi€lfc5 /lfe
, '/
Address?c 8B~ /7<11
City
1l1-f3thJV
Phone 5Y/-92-6,-5&6zL
.Supervisor License Number '7 LdCf
Expira tion Da te /~/tJ(/()z.
Constr Contr. Number /00561
Expiration Date b-l,7-0<f
Signature of Supervising Electrician
" ,~?--
, t~
Owners Name '5ffftW Ai S' ft.1i'TII
Address,::rL/II. f1/t(f3ufsID~
Ci ~y.s..pRlrJ~'t:(~LO Phone
OVNER INSTALLATION
The installation is being made on
property Ioww whi~h is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: ~1~~If'lG
RECEIPT tt:. 04 g ~
RECEIVED BY: iN..b
8
_0
AMT RECD:2 $ 22.00
CHANGE:
CASHIER:059
-~CAL PERMIT APPLICATION
00-000t.{Q,'-O I
cit'y- Job Number
3. COMPLETE FEE SCHEDULE BELOV
. A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
Items' ,Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
200 amps or less $ 50.00
201 a~~T~e400 amps _ $ 60.00
401 ~R~ to~OO amps $100.00
601 am~~P~BNa.~e~ a~~s $130.00
over41.fO'QORr~/v~!:tg;^PIRF /f=T~~OO. 00
RecQ,l9f5TI~lENO]tfyUNDER THIS '"'- ':;l ~QiJW(
CEO OR IS ' I cRMIT IS NO-'
Tem~~-r<1~ lJtW~ifies ~fI{Q@,lri€!~ f
Installation, ~~/~,ation or RJi~cation
200 amps' 'or less
20t amps to 400 amps
Over 401 to 600 amps
1Dver 600 amps or 1000 volts
'\fTE,\ '
. ; ; ~,;, ~ .
D.Brancall~1f8MstsVlo~vr .av., ' -
'otification C aaOpted by th~ ;1Ulff;:t. !OU I'. '
New,1 QA~!d8pt~rrn~Pd7i.g%<J~t1tm~nel
, 10~O. YOu~a .001.0 through QAare set WJ:t. ,~ ~'f
One ~ . Y obtam CO' ," - "'fS952~
Eac~ @&glDter. (No ~8 uf the rules. .
'''''.';: ,'. CirClll t r Qrtbe~~~~tPete/epho le-. b)
r,; . or,. Feed ~"~!Rnn.~' ,tYNottNca:'o'-uO
~~" . '''J~'44) (n
'.', ." ,,' ) "''7.~\14
E. MisceIlaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
c.
5. SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see "B" above
..
$ 40.... 00
$ 40.00
$20.00
$ 36.00
20.00
... 2z....0'O