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HomeMy WebLinkAboutPermit Electrical 2001-1-8 The fOllOWing ro' _ Zoning, and P Ject as sUbmitted' , , apprOVal' does not require s e h.~s the fol/owln 225 FIFTH STREET ~ . J P ClflC land Use ~LECTRICAL PERHITAPPLICATION SPRINGFIELD, OREGON ~.7 4 77 on/l)g _-<.1) f2- " INSPECTION REQUEST: -m~ / -1_::..011 - _Ci ty J~b NumberO 0 ' 01 'S S-'i.;" t!.> ( OFFICE: 726-3759 AUfrlorized S' --..t4 I _ Ignature IU 3. COHl'LBJ..ti FEE SCHEDULE BELOV 1. LOCATION OF INSTALLATION -- ~5.3S'i(' J//J1jjl..I/'(r"t:Le- ,A. New Residential-Single or Multi-Family per dwelling unit. Service Included: LEGAL DESCRIPTION /702. f7'fs og:5C>:::> , JOB DESCRIPTION J""'rf'-U/d-./-( :%?1W~ ,I I;" fh Zt.u;t e.a..ua~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Items' 1000 sq.ft. or less Each additional 500 sq. ft or portion , thereof Each Manuf'd Home, or Modular 'Dwelling Service or Feeder 2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders n . t - Installation, Alterations Electrical Con trac tor')--)t' "!fYl-OJ d....l~ I f1t!-+r~/'lLc/p"r Relocation: Address PO. Aox LfO_?c..f<j( ,200 amps or less ' , 201 amps to 400 amps CityJ:u,()I/7/ Phone 5~/-1..1'8t/- 9tJJSl' 401 amps to 600 amps I ' 601 amps to 1000 amps Supervisor License Number 3_~ 31 .JLC Over 1000 amps/volts 7 Reconnect Only Expiration Date' ID tJl Cost Sum $ 85.00 $ 15.00 .$ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Constr Contr. Number /tf'itL3'5 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date &-/oV "ffTl?t~7&t~ Rlprtr~an v-t ~ - Owners Name_O (1(0';' r "Q Ubk (' f)l))(I-. Addre~s P. tJ. t3l?X_ -7-10115 Ci ty ~fLJ L Phone 5<{ I-,lL{ 7: -37 3D OVNERINSTALLATION The installation is being made on property I own whi~h is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: Of 0 ~O ( RECEIPT #: 1..-/ \ 9 '-( RECEIVED BY: J:J(( 200 amps"or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits New, Alteration or Extensisn Per Panel $ 35.00 One Circuit Each Additional Circuit or with Service or Feeder'Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res ~ Limited Energy/Comm - 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 55.00 $ 80.00 see "B" above ,. $ 2.00 not included)