HomeMy WebLinkAboutPermit Electrical 1999-10-5
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ThE lollowing project as submitted has the following
Lt,r\ll!\;i and does not require specific land use
~l-'jJlv"81 .
225 FIFTH STREET Zoning '-D fL.
SPRINGFIELD. OREGON 97477 rJr 1()-~-CJq
INSPECTION REQUEST.. nf}2'['D7 ~
OFFICE: 726-3759 ,.,,,,nuf'.dQ Signature
3 . COMPLETE PEE SCHEDULE BELOI/
?'I>CTRICAL PERMIT APPLICATION
\;1'ty Job Number 11/200
Electrical Contractor /.tt<T?L
Address ty 6'7 /hf!;P ~
City P..u~/JL Phone (gg$>-S40f
upeL'visor License Number 41-'55 ~
Date ~(--35c..V\
J C.
Constr Contr. Number 10 -I-of
xpiratio Date ID~/~I
. . /'
C/ '"' of S"P"~~'"<'"i<i"
olner~ Name ~~1/'1 ~$.
~~. /? A.J "t ,.,.;,
One Circuit
City JfUN(#1/l.//J Pho~,e '7<'{Y-6q~~ Each Additional
Circuit or vith Serviee
OIINER INSTALLATWl!>rlCE: or Feeder per~i t $ 2.00
The installation isT~Ri~~~~I~" E. Miscellaneou6 (Service/feeder not included
property I ovn Whicl\um~iEbnte'O'de'(l'\P/RE'FTHEI1I~!:J installation
for sale. lease or el5~M UNDERTH/SPERMlTI"tiP/ilI'or irrigation $ 40.00
ENCEDORISAB it.lJliVOutline Lighting $ 40.00
Ovners Signature: ANY180DAYPERIO ANDONEDF~mited Energy/Res $ 20.00
0, Limited Energy/Comm $ 36.00
I r5"<M/
fr.-~
, 7.:JU
17 (j ;:J(IJ
Temporary Services or Feeders
: Installation, Alteration or Relocation
. ...
L(o -
1. LOr.ATION OF .INSTALLATIg,N " /I
---.:.' 316 l- G::,i' f1JtJ~
'Yc.AL DESClUPTION If6') otrl ~ o/90()
.....u'. 1 :' /D .'l .
, ,
A.
Nev Residential-Single or
Hulti-Family per dvelling
Service Included:
Items
I
J~ofF Sof!1'
JOB DESCRIPTION 1000 sq. ft. .Or less
~, ~ L &O;'I~ . Each addi tional 500
, . /,., , ". .'. : 'sq. ft or portion
Permi ts are non-transferable and expire, . thereof
if vork is not started -ili'thin 180 days "'j ". r~Each Manuf'd Home. or
of issuance or if vork)i;lsuspended for "~~;. 'H~dular'Dvelling
, !J. ... ~
180 days. f1':b" '. ~ cSi!rv-ice or Feeder
C' . _ ~ p,... ,. 'e.
( I . ~ PO..., \..'
2. CONTRACTOR INSTALLATION ONLYC- " . ", .B. Services' or Feeders
. 'J. ", ""Ins,tali'ation, Alterations
, r . -.' y
1f:.{~L ',' orlRelocation:
__ '1'0 W' "'\ .....y
. Ific..: t.s .
i. 20.0 amps or less
201 amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
200 amp~.oT less ~
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
uni t.
Cost
Sum
fj5"'
~tP
$85.00
_. 2-s 15.00
.$ 40.00
$ 50,00
$ 60.00
$100.00
$130.00
$300.00
$1,0.00
$ 40.00
$ 55.00
$ 80.00
see "B" above
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Address
Nell, Alteration or Extension Per Panel
~~~~~-:~---~~:~~---~
RECEIVED BY: 'V xt JY:!:. ~
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
5.
\
$ 35.00