HomeMy WebLinkAboutPermit Electrical 1997-8-11
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225 FIFTH STREET ~ Y A o~ {9 i9 ~ ~~ ~'
SPRINGFIELD, OREGON 9747Yhef 1(S'I;70A ~$-i t9,.o~ ~~
INSPECTION REQUEST: 726Z0ll1~~~~~proje~RG ~~~ ~Q Ci ty Job Number
OFFICE: 726-3759 approval, does not ra~ ::;i~g~~4; fOlio""
, ~~ec"~)IIBk.EJ'E'I''}3EE SCHEDULE BELO'J
1. LOCATION OF INSTALLATION Zonir ~
:GOff A-/{M AV(J DFJ.teX--/l_ - -J'lew ~esid~ntial-Single. or .
Auth '~ ',~ ' , Mul tl-Faffilly per dvell1ng Unl t.
, LEGAL DESCRIPTION Of/",t.'d Signatui$ NA..1. Service Included:
I 7 D :, .13 33 03hC1O ~~
---
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
JOB DESCRIPTION ~
<pa V'O...I oj.". 3 lAY rJ,A !-'/ ~
Permits are non-transferable and expIre
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
ELECTRICAL PERMIT APPLICATION
q 7/J09
Items
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor CriCSOIl cleclr/c>kc.or Relocation:
Address P- 0, ~(Jj( ,;7 200 amps or less ~
. 97~qg 201 amps to 400 amps
Ci ty JVJ1clidA u"'l~Phone 9?f~5i'l(~ 401 amps to 600 amps
/ 601 amps to 1000 amps
Supervisor License Number .3r;77 ~ Over 1000 amps/volts
Reconnect Only
/()~/- 97
Constr Contr. Number ~~' Q5Q0<1 C.
Expiration Date "r70aI~ /-b-1J1
Expiration Date
Signature of, Supervising Electrician
>~::;Z,~-'~
~ovners Name ~Y\JV\ C' S~ >>1.LJUr D.
J I
Address JfJg klfivt ~ Ave.-
Ci ty~~' P.Jd Phone5lfl-7f.{7-/~ 1S-
(
OVNER STALLATION
The installation is being made on
property I ovn vhich is not intended
for sale" lease or ren t.
Owners Signature:
---------------------------------------
DATE: '6~{I-q7
RECEIPT t\:: .27(137
RECEIVED BY: tv
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
,$ 60.00
$100.00
$130.00
$300.00
$ 40.00
56
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
Nev, Alteration or Extension Per Panel
$ 35.00
$
G
Branch Circuits
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit ~
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 5 h .00
5% S ta t e Surcharge :J.. . 'i?O
3% Administrative Fee I . 6R
TOTAL -6.(') if$'