HomeMy WebLinkAboutPermit Electrical 1999-8-5
NOlIe!:: ,.ELEr.TRTCAL PERMIT APPLICATION
97477fHISPERM1TSHALLEXPIREIFTHEWORi\--- aa
726-~-fflORIZEDUNDERTHISPERMITI~fiJW Job Number II ~ 'i'z 2-
COMMENCEDORISAB!~~~lT& FEE SCHEDULE BELOY
L LOCATION OF INSTALLATAWi180DAYPERIOD.
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, LEGAL'DESCRIPTION _I? (P6'f (1,01.(100
\ '"' '" oil .,; 1- ..J."::' \~, J l' ~ L '" -\- , fa
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
JOB DESCRIPTION
) 00 C\~ p s..'<>."u~"-:",,, ~\"",\; \)
Permits are non-transferable and expire
if york is not started vithin 180,days
of issuance or if york is suspended for
180 days,
2.
CONTRACTOR INSTALLATION ONLY
Address '3'-:1 '1 8 'i ~..... -5 1-';-(,
City FJo,,_.N~'<.
Expira tion Oa te
Constr Contr, Number;) 0-3'/(;, '-C
Expiration Date
\C,-\--::'u
, Signature of Supervising Elec:J' 'an
~((
(I \ ~14(
Ovners Name tIc.,~.... /AI' 53 '0 ~ .> ~ ...J
Address
1'1"
)..J--.J.~ 71 NO
Phone 6 ,J ,r- ~ g 'J 7
Ci ty C-j '. .,.~....
OllNER INSTALLATION
The installation is being made on E.
property I ovn vhich is not intended
for sale, lease or rent,
ovner~ture:
'- ~
-r 5.
~~~~:~-:~f!fo/--~~~~:~---~;;:;jJ
RECEIVED BY: It
Nev Residential-Single or
Multi-Family per dvelling unit,
Service Included:
Items
1000 sq.ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modulat:. 'Dvelling
Service or 'Feeder
D.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
,B, Services or Feeders
, Installation, Alterations
Electrical Contractor rtl-".."., (\,.; fi.-/~JiK:;-,or Relocation:
f " 1~,lJl"g(Jl' oW I eqUlre~ you 1<.. I
L- i\'lj,~W ;.oles ad2'6b3ralill>S1(0r>r'li~ssUtilily
" oa Ion C~n201 Ta;nlis nto-s40,Os!!\IlPJHI'
Phone S Cl)- <~~Zil~1'4"0I])~amp'Slgto::>,6P,OJ'!l:!npel'
- " ou may 16t!11l1ramp;sietoJf +:Q9PJI~!!1~s
Supervisor License Number .3 "/3) - ..<1*llling theceO:v.en:~1000,t.<!I1)P'.~~Y,8h&S >
. .1.. "Lor for the~"-onJ)~ltliIOnl~ltl'cat'
C oJ"" J I'''',:~ Ion
\ 0 - ) - ~ -::, enter is 1-800'332,?1441
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Cost
Sum
S 85.00
$ 15.00
I .$ 40,00 '(6
$ 50.00
$ 60,00
$100,00
$130,00
$300.00
$ 40.00
S?)
$ 40,00
$ 55.00
$ 80.00
see nB" above
.'
,
Nev, Alteration' or Extension Per Panel
One Circuit $ 35.00
Each Additional .~,
Circuit or vith Service? ~
or Feeder Permit ) $ 2.00
Miscellaneous (Service/feeder not include~)
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
'l'loSta te Surcharge
37. Administrative Fee
TOTAL
$ 40.00 _
$ 40,00 _
$ 20,00 _
~j'OO _
,16.rJD
~,~O
/oe flU'
.