HomeMy WebLinkAboutPermit Electrical 1999-11-4
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The f9\10WI,n'g:P~Oj,!ct~s SUb.n:; s~eCifiC land use
loilliig'a.nddoes not reqUlr () , '
225, FIFTH HSTREET approv_~I, ,. ' L-- 0 ~ , ,EI..ECTRICAL 'PERMI'l', .APPLICATION
SPRINGFIELD, OREGON 97477 ' Zoning', 'l _ q - q q a
INSPECTION REQUES'r: 7&%-lliQ \, I Ci.ty Job Number /9 J L//9
OFFICE: 726-3759 f~utnOnZE:O Signature - Cf3. COMPLETE FEE SCHEDULE BELO\/'
1. LOCATION OF INSTALLATION U:
/l~.~ JQnc:Jl"f60/\ kOn.C,. , A.
Sp" ~ Y1sG';e 101
LEGAL DESCRIPTION, 'QILj 18
hto.o-\- r,-,~-r '+- a \ v Irtord I to y ,
JOB DESCRIPTION
/7() '3 ')" 3 '3
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft.' or less
11/00 NOTICE" Each addi tional, 500
. " , sq. ft or port1on
~ermi ts ,:re non- t rans fer,:bl~ aThtI~RmSHALL E::~~~t.l-fr_,^,
1f work 1S not started w1th1n ~~~ ~~~ ~~LHarto~u~e, or
of issuance Ol- if work is sus~~'ellt''l!{,~DUNDERTlHJ81P.6RMJ:rvf$N{j.'pg
180 days. COMMENCEDORISABAwOO~eD<FbReeder
2. CONTRACTOR INSTALLATION 0zft.f'tY180DAYPE~IPDServices or Feeders
~ Installation, Alterations
Electrical contractori)\JX~ ~(QcJrj~ or Relocation:
'Add~~ss 3?Jl:lIJ ())~ '1Y/{;lr-tiYG 200 amps or less
;1.r 201 amps: to' 400 amps
Ci ty U tEiJ.JLif Phone ~q5- 241-10 401 amps to 600 amps
601 amps to 1000 amps
Supervisor License Number .::;LolLI -S Over 1000 amps/vol ts
Date 1'0/1/00 Reconne,ct 'Only
Expiration
.1'0 ~gor"\ '!:I'^/.I('\n1 \IrA~ "OU to
(f)1 ,.,<2011 ,ATTEN IIUI'\&. r",.. ''Femp()"r:ary~ Ser:Vlces or Feeders
Cons tr Con t r. Number U/C)'1'-ffollow rules adopted lrnsiit%~l%.\{.'folrl\ullt)l1 tera tion or Reloca t ion
I Notification Center. Those rules are set forth ,
Expiration Date /J/<B '6/ in()Ai=lq~2-001-0010t~()(i)J[a:-m?~;?&5~:t~Qk $ 40.00
~090,. You may obtain ~~~'iEam'p~s.h,t~U~@'OJ2mps $ 55.00
Sigp;,rj:ure of Super~ising Elec rc~~tHgthecenter. (lg~~),-.t~~~~!~~~::'~~:~ a~b~o $ 80;,~~
numberforthe Oregl:1l>{Et,Rlh... .'.09!1~IC0a.- vol ts see above
C:;--:ted~ i-800-332-~:344). .
~ J D. Branch C1rcu1ts
tlIIU--': i..- I/U lId C Ie
Address /h()() /:2h tRlIo,!Je/)c$~1V
Ci ty FLo/L.l?1rJ Phone tf4 7;' Jf-'1~
"
Items
Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
,.
New, Alteration or Extension Per Panel
OVNER INSTALLATION
One Circuit
Each Additional
Circuit or with Service/
or Feeder Permit /
/
~.(,
$ 35.00
$
1---
2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
The installation is being made on
property I own which is not intended
,/ for sale, lease or rent.
E.
/
/
Owners Signature:
---------------t-t---------------------
DATE: / (/ 4f 17'
RECEIPT #: ' /-' I'(p?.(",/OS"
RECEIVED BY: p tJaA#
5. SUBTOTAL OF ABOVE
V27. State Surcharge
.3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
~, .00
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