HomeMy WebLinkAboutPermit Electrical 1998-6-11
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
" ' bmlttecl has the foil
The. followmg project as suI a~\flc land U6<l
zoning. and does not requre "l"'--
approval.
Zonina \ ~V .
97477 . JO-1I -4 g .
726-:m~ ^ m
, Authorized Slgnatl/l"'_ .
. 3 . COMPLETE FEE SCHEDULE BELOW'
ELECTRICAL PERMIT APPLICATION
Ci t)' Job .Number 9 ~O.5- C::, I-
1. LOCATION OF INSTALLATION
J $"1O / ~A/ <" T,
LEGAL DES~PTION
J 7 D -S, 4 2- 3
D /68/
JOB DESCRIPTION
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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
i
i
j
Address
'<
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
200 amps"or less ~ $ 40.00 4p-o
201 amps to 400 amps $ 55.00
Over 401 t0600'amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D. Branch Circuits , .",:. .
Signa.ture of Supervising Electrician
Owners Name_~~ j/{.L1~tJ-~
Address 5""72 5' ~.-4?'&<Y ~ /,S-?
Ci ty 5)f(~ . <]},i1~Phone~ 21~ /
OVNER INSTALLATION
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
The installation is being made on
property.r own which is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE df') fJ!:)
5% State Surcharge ( z;-o _
3% Adminis tra ti ve Fee /,4-0
TOTAL .//7 2-/0
1-'
Ovnets Signature:
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~~~A~E~----Q-----~;;;;;~-~-------------
RECEIPT #: (' ( 5/)2 7)~
RECEIVED BY: . ./~...,
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