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HomeMy WebLinkAboutPermit Electrical 1998-8-20 .v ~onii1g, and doeS not require specific Ian approval. r 1 ' NOTIC~/onl""1 g' li ! .. THIS ~~ 1l?rXu. EXi1!~9.IF THE WORllLECTRICAL PERMIT APPLICATION d~ldmature;IY~~ . 9bb~~E~CeD~R 1~:~~~~N~~~~:O!i ty Job Number. 1f!6tjO , , ' ANY 180 D.~,y PEAIOD. 3. COMPLETE FEE SCHEDULEBELO'iJ 1. LOCATION OF INSTALLATION . \ 3 \ 5 AS P €rJ ~ l. ' 'J LEGAL DESCRIPTION 1163 Jf 34 ~>I\lTe: N N. \ A L l::.l e:Jv\€:.N~ JOB DESCRIPTION ~. . V,RF': Al-A~ ~U"'U~ " \ '\ _"'!i ~., ~ 225 FIFTH STREET, SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number \()73DS I Expiration Date If) - Cf'iS Constr Contr. Number Expiration Date Signature of Supervising Electrician d (\.L~ Q '_'LV. \~:!~IL(Name . S-,f R:"'<y+', """ Address \ xC] D Al.' t...(Q..,u.;2. Ci ty. s:~ u'\u 'Y~ll,.-.(1) Phone f7q~ ~(-:J 3?5 OVNER INSTALLATION The installation is being made on property I own whi~h is not intended for sale, lease or rent. A. ()7Ao/ New"Residential-Single or Multi-Family per dwelling unit. Service Included: Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 1000sq.ft. or less Each additional 500 sq. ft orpertion thereof i; Each Manuf'd Home, or Modular Dwelling Ser~ice Dr Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fe~ TOTAL C. Temporary Services or Feeders Installation, Alteration or Relocation A~ftNilffi~:~9.Q!1;~W requires YO~i~~1 40.00 foKm, ro~dlopt~qbgy !~'Ppr~t f rtt:i5. 00 Nodl~~Q1ertter.6D@~f}!e5 are s _ 1~0 . 00 in c9A'Fr'95~tJ.(j)(}tOth.ro~gb~~ Sby "B" above 00 O. You may obtain copies of the ru es , D. ~~rftRg~he:MA*.t(t.Jote: .t~e tel~~ho~e .,; 3.'cJ"\O'b \..l:>\'~. ~mberfortheOregon Utility NotIfication ew, .6~ntetffsl:~Oi~~2~~ion Per Panel OneCirc~it I $ 35.00 Each Additional Circuit or with Service or Feeder fermit Items Cost Sum $ 85.00 $ 15.00 . $ 40.00 , $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 fl \??_-: \~ . L-n- -'3.-.-'....- .._~~- _fJ/7].f8JrK