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HomeMy WebLinkAboutPermit Electrical 2002-10-11 ..' e\ . \ '- i 225 FIFTH STREET . . ,." SPRINGFIELD, OREGON 97477 INSPECTION REQUfST: 726-3769 . ,I OFFICE: 726-3759 ELEaCAL PERl'vIlT APPLICATION dtyJob Numher t:c..e7.-DOL- 00/0% ""~Expiration Date -;-:X/? OIIJV 200 amps or less -- _. 20 I amps to 400 amps Signatnre of Supervising Electrician - "- Over 401 to 600 amps . . V Over 600 amps or 1000 voils see ,....r. 1)' , "8" aboye . \J~ "" (/i i ~\\ , I/i' . D. Branch Circuits \f~\\~ 'iIIO n1 Owncrs Name6'tes < 1/1.G..WJ }, 4-lae.. C~: Newtt~'\l1?J\~ f?~~~fPanel . " . ~O"\\. ~\1 ~\\ CQ. '\\\\S ~ ~\) fO\\ > Address :J~(~() 7?rJ....fl.J1iu-a-.r-zl i\\\S ~t.~ It.\9~~'i~~f>.~\)O~ -L $43.00 L . . . ~,\\O~\ ~O\\\S. . .. .' . C.ty~ ,~/) Phone? ,/i.(-!:fs:, (f~Q\'lI"'t.~C 'IF,_~IJaI C.rcUlI or mth sente. ? ~\'( '\~\) ~"eeder Penmt ,,\0 $ 3.00 ..L.. OWNER INSTALLATION t\>'... \l\~e,;'>O\I\\\'1. . The installation is being made on E. !\liscella.ne?1!s'(S.f.j:iccJfeeU'ct :t9.t:included) property I O\\'ll which is not intended ."Ehc.hi(l~tall~tiob: "iL- c.'~~ (\0"'- for sale, lease orrent . .'.Puilip 'or ~1JigM;i5a-\.'~ ".fl. ',' ~~ '0'1 ---.:... $50.00 _ r:J.........' .> - ~u- \ ,I. ,\)......... ,\ -",. ,Slgn/OuHi!,e,~igl!I\l\g,) (Ie _ $50.00_ ..,..J'<' "~\imit~d~~ll~~gylRd\)Sv:O \\0'(\ _ $25.00_ . ", j"J C\\ Lil1!ited En,rgy/C;:oilllllO\i\\e,3: _ $45.00 _ \" .\\l'J ~~.)... .\--,.I,"IJ . . ., SJ (i\' ~~f\\$(' '," \J\I'\" ",b/~' ':(.lI1inimum"ElectricTel'miUhspection Fcc is 545.00 + Surchal'''cs .." .....\\\\._~ - ,":\...-"" ,,'U..J.'- b ~~'4:.\Jg&,Bl~~fK~'~'F ABOVE C(-6 70/0 State Surcharge 8% Administrati"e Fcc , I - i : I 1 \- . L LOCATIOlL{>F !J.'!STALLATION I 3~(,o -':k' aY #~1.. i~~, ~ ;;;L- LEGAL DESCRIPTION /703.2-'t../3 Zo3~c::. " 'I I ~. COMPLETE FEE SCHEDULE BELOW " , . i - A. New Residentbrl-Single or Multi-Family per dwelling unit. Ser"ice Included: , . JOl\ I?ESCRIPTIpN . / / .~ 1000 sq.ft. or less fi1 ~ ~>'J~~ r- Ia.4::f a,"l&ill!~ \l4Id~t 500 ()I),k> SC,. ft or \lll'1ill-lb PermilS arc non-transferable anrl "T:" t-o- /l ~ UJ thereof if work is not started within 180 davs !':R~I~Manufd Home or of issuance or if work is suspendedfor -U<11 Modular l!l*lJlIIWg ~1IB 'QUlP'?.!' 180 days. al o'lloads aJ,nba, 10uSCl'lij 'or fo1~ esn pu , . qns sa .:laloJd u!MOll _ DUIMOIlOl 941 sa4 peU!W . 2. CONT~CTOR INST ALLA TION ONLY B. SCI'"ices or Feeders , , 11 Installation, AlIerations or Electrical Contractor ks f-f"L~;" '1 (0'<A("t..H/f\:: .Relocation: /' " Address O. () : (j?'lN' 2- 07,?f /' · ''-, 200 amps or less' 201 amps to 400 amps Phone b-(tI'-t,2J t. 401 amps to 600 amps J 60 I amps to 1000 amps Over 1000 amps/volls f Reconnect Only City Eo~; u \ ". Supervisor Lieense:Number J l{C(7 S ) './ Expiration Date 10/1 /0<'1 ,r' . '-Constr ContL Number 70%)?9 C. TemllOrary Services or Feeders Installation, AlIeration or Rclocation On-'Ilers Signature: . TOTAL Items COSI Sunl $106.00 $ 19.00 $ 50.00 '_$63.00_ ~$75.00_ . $125.00 $163.00 $375.00 $ 50.00 $50.00 $69.00 $100.00 ~2 ~