HomeMy WebLinkAboutPermit Electrical 1998-11-25
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Zclnina l 'tl.~ . ELECTRICAL PERMIT APPLICATION
9?AZZ w"...rC'~' 90" "l4-r2
/'co~ l Ci ty Job Number 0 0<. I.;jJ
Authorlzed Slgnatute . \ij
_______ J. ~U"'~'_ ~"'r. SCHEDULE BELOI/
1. LQCATION OF INSTALLATION
4 &3 t,J. OIJIl.l~l-1 51 . A.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
NOTICE:
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
It ems Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00.
Each Manuf'd Home. or
Modular 'Dvelling
Service or Feeder .$ 40.00
2. CONTRACTOR IN~!;;{\:'!:J!9rs~P,[t%XPIREIFTH~' Services ~r Feeders .
AIIT ;~~;;:;'~~.r; WOI]Kstallatlon, Alteratlons
Electrical Contract~~~tWl~ITISN13r Relocation:
Address / / / / ~~;qNJ2.., R$~~NDONED FOR 200 amps or less
(") ..", 'wu", n:NJY.U.J7~.rHf 201 amps to 400 amps
City V(,{5;::j/J~ Phone (fj;f)&>i'177!7~ 401 amps to. 600 amps
601 amps to 1000 amps
Supervisor Li cense Number 3 :)2.3 oS Over 1000 amps/vol ts
Reconnect. Only
2-80/
. _ ~ 'bgS' C. Temporary Services or Feeders
~1"L Installation Al tttfation or Relocation
ATTENTION:Oregon law reqUITeS you: .
Expiration Date od /0-- C; 9 ,nllnwrulesadoIlOOlIa:m\l1l''dfSmytlhty
. . lIIotilication Cent&iOrhalll{lsu1tl6 l:''{Me~tIl1J1
Signature of Supervising Electri~i\-fflAR952-001-0lJIIl0:t~~~~Q\ ~,~
- ~/. / - /J IM90. You may o\\~11 ~Slllip.$led'l.lle:f{ ~
~~ ~7--vu/ A ~-"::lgthe center. (Note: thetel~~ho~e
r . n-- erlcRthe~~\lh LCil~b1!l\jlicatlOn
Ovners Name_.h6iJ51 A.I<<: Itd6>'i^J7'/ !,'i~~eris 1-800-332-2344).
~ )/1L_'e 5 - A54-C-Y - Nev, Al tera tion or Extension Per Panel
Address~/.} C-J. FAI"_';,';;'"..! 'Da..
Ci ty 1r.;1/ If;~ p,~L:PI'honeCo<8'.;2 -40 fO
OI/NER INSTALLATION
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Expiration Date 0 C-I /0
~-
Cons tr Con tr. Number <
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
-----------~-----~----~--7------------
DATE: .)~/5(. /IfH/fD
RECEIPT 1I: () j ~ /J" //
RECEIVED BY: d tJ~
I
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above
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/
$ 35.00 5("
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
2.00
~
?
$
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lightin~ $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 'if f) 0
5% State Surcharge ?" <'
3% Administrative Fee I .1.~.
TOTAL '1'u- L '{