HomeMy WebLinkAboutPermit Electrical 1995-6-22
. .
he fOllowing project as s b Ittad . .
zoning, and does not r"-" ~ m , ~as the following
approval. . -....ulre specifiC lend use
. Zoning L{) () _
Data Ccr 2-24)
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
9T4jy:rprized Signature N M
726-3769
1. LOCATION OF INSTALLA~I~~./ /L'
_~?C22-- ~c ~ 7eej. .~ (i~
LEGAL DESCRIPTION
/7L.>2- ~-f #- ~~,
~t;~~ON
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
ELEFCAL PERMIT APPLICATION
.~y Job Number75D:! 5'"?
3. COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq. ft. or less '"Z.. $ 85.00 L20
Each additional 500
sq. ft or portion
the'reof 2-. $ 15.00 .3::>
Each Manuf'd Home, or
Modular Dwelling
Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
r ~ Installation, Alterations
Electrical Contractor L e. E: (E\~c.... or Relocation:
Address 4\01 JB~€)") 1)f'L
City ~~t Phone_lo~~.t:tf)S1
Supervisor License Number Z~ ,t1-$
Expiration Date 10- ( -q 7
Constr Contr. Number IOr41~
Expiration Date 3-30- tth
Si~~erVi~Cian
/ , D.
Owner s Name ?)1LA-.AJ1C ~A::;:~"~.?~(_
Address 5~ ~ C~..# ~ A.
City JA~ Phone 7~~ -2'~t
( ,
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~ATE~-------7~~-~~-:~~~------------
RECEIPT #: I 1* '?
RECEIVED BY: I~
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amp~~r less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
-$ 80.00
volts see "B" above
Branch Circuits
,.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
2L:TD ,.cro
./ ~ .0
G- 00
2/~,~
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL