HomeMy WebLinkAboutPermit Electrical 1996-11-14
Th': lo\'owln" proj'ect s,r. submitted h3S the 1a:ICNting.
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225 FIFTH STREET I rVJ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zooir,g (/IAt/
INSPECTION REQUEST: 72~.1l6~ I =--Ll:'..:::.rtv, Ci ty Job Number c;r 0/ II ()~
OFFICE: 726-3759 ~ -t llnA
Authorized Slgnatu'o_--1~Y.L.{;OKP-hE'l'B-PEE SCHEDULE BELOII
1.' LOCATION OF INSTALLATION r- _ ('_II
~(")S<f'l ~ ~+Ir1"'t":t- - ~ A. Ne1J Residential-Single or
Mult i-Family per d1Jelling uni t. ,
LEGAL DESCRIPTION Service Included:
/ /-Or ~-o/ /' , /?,&?Z> I terns Cos t Sum
,
JOB DESCRIPTIO~ 7/- , '
Bh~. A:;..)'l'l' _ r~~pa:-c ".
. l
Permits are non-transferable and expire
if 1Jork is not started 1Jithin 180 days
of issuance or if 1Jork is suspended for
l80'days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor__f)Jj7~' 2=~~~
Address B.2.j /'J.... j:) A. H 1-~' A l... tJ
,
Ci ty FL",f..E AI e., Phone Pi q- ;'S'(j- P
Supervisor License Number t:i g-s,
Expiration Da'te IlJ- 1'- "j7
Constr Conn. Number d-c-/7C
Expiration Date 10- 1- 7"7
Signature of Supervising Electrician
/)~~, );G~ '
01Jners Name~ J {
Address 2[,,\C:;" F s,t-:. ~q
Cit~~jr:Lphone~
OIlNER INSTALLATION
The installation is being made on
property I O1Jn 1Jhich is not intended
for sale, lease or rent,
Owners Signature:
--------------------------------~------
DATE:_ //-(q'-~
RECEIPT Il: ~~.:;;
RECEIVED BY: //' -""'/2-, ,
'R'p-'-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular 'D1Jelling
Service or 'Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less I
201 amps to 400 amps
401 amps to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 85.00
$ 15.00
..:
:$ 40.00
$ 50.00 5f>
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see IIBII above
.'
Ne1J, Alteration or Extension Per Panel
35,-
One Circuit --V $ j).U~
Each Additional
Circuit or 1Jith Servic~,
or Feeder Permit .~ $ 2.00
/D
not included)
Miscellaneous (Service/feeder
-Each installation
PUlTlp or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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