HomeMy WebLinkAboutPermit Electrical 2001-1-30
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. .DATE:JAN 30 2001
AMT RECD: 2 $ 88.00
CHANGE:
ELECfKICAL PERMIT APPLICATION CASHIER: 059
The, following project as submitted has the tollow
zoning, and does not require specific land use
approval.
Zoning f j1
225 FIFTH STREET Date 1- "10 -0 '~
SPRINGFIELD, OREGON 97477 .. .
INSPECTION REQUEST: 726_ffl&nzed Signature ~
OFFICE: 726-3759
-1.
LOCATION OF INSTALLATION
'i)'1() ~lf/!~~
LEGAL DESCRIPTION
1'7-0~/SsCj 00<:900
.JOB DESCRIPTION (J'II D ..~ \ .. ~
T~ ~/J' - .,e~}5/ft)
Permits are non-transferable and expire
if work ,is ..notstarted within 180 days.
of issuance. ot- if work is suspended for
180 days.
r.itv Job Number
3. . COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
o o.~ Or:?-q (Y - 0 J
. Items Cos t
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof' $ 15.00
Each Manuf'd Home ot
Modula~Dwelling
Service or Feeder -$ 40.00
,:8;- Services or Feeders
. ",;01/\ ilhstil}l?-tion, Alterations
:J:J rY. E.. ct.. . jl!IIC~ r ~. -/....1'" .' , 'r
I=:. 1 ' 'C.i"rrlo:r, 'Reloca't l'o'n"<:_." ,.
Electrical Contractor.' NFINJ , pC,.; .-" O/'.q. fl. _ ....-..'"1(;~: ;-'1.-' '.'. \"Jr:JQ{lr,! 'j.
M" ...." 0-0 . ")~'- I ", I'.
Address:2 3:? .;p.~ N C fJ.;4I.V.r"1'-' f<p 0090. Yo~fOO 1;Mbl~(j0:r;~1~~~S :;!rr:.c S~t ~{.
. , ' _ . c. 'a/line 2IQ~Y alhp.~$int~;lr!J. ~.QO Q. ~{fjs)52-;);l '
. r ~ ~ .~ '" ..j ,- . .. r . -, .\-~ Of;'/..
. Ci ty 8rus "- fJ~til/"'~ . Phone ;::. 03~cyOCj-()[; g,l,.P.'DOt::n'&Pt~a!jf1pSil'~8{,_69...0 ;a~p's'U/A~ jo.,
c.J(}. ... r;,,6011""amR~j0to, ~A.000Ga:n}JI;;)n" -
S~pervisor License Number ;;U.p 8'7- S. ""O'Vet-; 10(ro,:ta:~'p.gYvb:WjYj~'2+;~~
_Reconnect OnlY"',-141 -....".
2.
CONTRACTOR INSTALLATION ONLY
Expiration Date
/0/0 i
C. Temporary Services or Feeders
Installation, Alteration or Relocation
, "" . 200 amp's' 'or less . $40.00
.; ',".-,Z:CH amps to 400 amps - $ 55.00
Signa ture of Supervising Electrician T'''liS pCROAver 401 to 600 amps $ 80.00
Q ~ '- I"'']:''H
il . A'f7'HO O've,r 1.6,~Ql::amps or 1000 volts see "B" above
. ~rc" - . - ^.,- f j RfZED U I ~c;/\I- diE' IF TH
(/ .. ~Ofv1fFjfNcB.~an~RFel'Hdlif.itt(SRM E WORt<
Owners Na~e C:~U1r',u.,^ ~ D..R..\\-eJQ,ff~NY18~DA~u~RISA8AN;.~~, 1~/SNO'f .
"'2 ; I, . \' \/ . L Ne~_;R~tJ:erat10nEldr(1j:f'tenslon Per Panel
Address J LjtJ:S Eo.. 0'0'-'1 V ~ GlliV' h.. .
~ One CIrcuit
City .Jpll{'l{ Phone ?l.[G-g"-itiL/ Each Additional
D Circui t or wi th .Service ~ ()
OlINER INSTALLATION O,r Feeder Fermit 15 $ 2.00 3'V
ConstrContr. Number ':1)- tptp 9- c
Expiration Date
I 0 - ()/- {) I
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
. DATE: I, .~(lJ- 01
RECEIPT #: -'13 <fJ-(
RECEIVED, BY: w :)
E. _Miscellaneous (Service/feeder
-Each installation
Pump o~ irrigation
Sign/Outli.ne Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 50'.00
$ 60.00
$100.00
$130.00
$300.00
$ .40.00
~
50
,.
$ 35.0Q
not included)
40.00
40.00
20.00
$
$
$
$ 36.00
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