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HomeMy WebLinkAboutPermit Electrical 1994-3-14 . . . . e 0 aw ng pro ect a. submitted has the f zoning, and does not require specific land u approval, 225 FIPTH STREET Zonln LnO SPRINGFIELD, OREGON 97471 g INSPECTION REQUEST: 726_376IJale.3-14-Q'-l City Job Number 9o/"~~7" OFFICE: 726-3759 Authorized Signature co., -1';~-Cott:>:s:.': :'llB--SGBEDULE BELOII 1. LOCATION OF INSTALLATION ~_9&' ..6>&>/(--'~-r- LEGAL DESCRIPTION /'/-.!!?J? ";;u::'- .y~- ~~?~ JOB DESCRIPTION ./",;:g,...,.~/~ P .:;9~~n....,~ .Permits are non-transferable and expire if work is not started within 1BO days of issuance or if work is suspended for lBO days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor /71t1"'7~' ..... - Address City Phone Supervisor License Number Expiration Date Constr Contr. Number ELECTRICAL PERMIT APPLICATION A. New Residential-Single or Multi-Family per dwelling Service Included: uni to Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or 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 $ B5.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or"Feeders Installation, Alteration or Relocation Expiration Date Signature of Supervising Electrician ;, Owners Name#.N.AA'5 ~~.5 Address "9'~ eP~.Ar".At L./"- Ci ty~ C;;:? Phone7Y;:>~98 r ~?P? OIINER INSTALLATION The installation is beiog made on property I own which is not intended for sale, lease or rent. OWners Signature: --------------------------------------- DATE: RECEIPT 11: RECEIVED BY: 3111-t 11\_'-' ) \Oij'"). \L~" 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Circui ts $ 40.00 $ 55.00 $ BO.OO vol.ts see "B" above New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit ~ $ Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL .-- $ 35.00 ~~ 2.00 tlS_/:JrO not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~ CI'I?_, ~. I'.fi.__ ~~/r ----. -