HomeMy WebLinkAboutPermit Electrical 1998-5-29
.
The fo~l('\winq project as submlttoo has the following
zoni~l' : i, .....as not require apectlic land L.I&t.\
BPIJI,)Jf..
Zonino hy~\ ~O~~
225 FIFTH STREET .D.a'-""\I"'\'1~ \~~'(\~ ~CAL PERMIT APPLICATION
SPRINGFIELD, OREGON 'f/'4~ ~\~~ ~~~ Q .
INSPECTION REQUEST: ~~ 'f'\~ 7o(.~ ~.(i1ty Job Number -L \'(D~ 1.../ tS
OFFICE: 726-3759 ",\\Vl;' ~'O'(..'f-'" G<;'~'(\\~ C\~~ .
~v ?~~~ '\)~'i)v 3...~~OHPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLAT~~ ~'V I(. \'O~"Q
/?f7 '"5-.-.>.>4 57 ~Y.t;~~lJ~' Nev Residential-Single or
. r. ~~'l;.\~ ~?~ Mul ti-Family per dvelling uni t.
J 7Y5.~ !}}JCBjP'(f10 0 lJJ~~'l \'Or:, O'f. Servi ce Included: Items
JOB DESCRIi'TION
~/r ~);A/'~
Permits are non-t:':nsferable and expire
if vork is not started vi thin 180 days
of issuance or if work is suspended for
180 days.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .Dvelling
Service or Feeder
Cost
Sum
(j) $ 85.00 ~1)
$ 15.00
, ":
$ 40.00
. i
2. CONTRACTORIN?TALLATION ONLY
Electrical Contracto~3 ~/~
B. Services or Feeders
Installation, Alterations
)C~,(~r Relocation:
,
Address 57:?;?f? I j)htCCJ;'~ "
j(J",p
C i t y::::}e fM ?J&...vL
OZ7~-:3 6t:',-?,
Phone
Supervisor License Number ~ "2 2.. Ci' ;3
Expiration Date (0 I af ,J ff'"
Constr Contr. Number {2 3 '77
Expiration Date 1/ } t1>/ I '}'R"
/
Signature of Supervising Electrician
~~J ' //~
Ovner~ Name !l.. D ~I/f_ /.) ad I)
Address 25D1 "11A./1.t.i.. c.l
200 amps or less
201 amps to 400 amps
q01 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 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
t D. Branch Circui ts
~K<,L~1
Nev, Alteration
Ci ty
one 1 r/6 -(tV II
f){)/J - 1/,4f<) ~
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Owners Signature:
,
~ATE~-------~~7---~-------------
RECEIPT JI:. I ngq.,q~
RECEIVED BY: ~J . I1Ilf~
,
volts
$ 40.00
$ 55.00
$ 80.00
see lIBtI
above
or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 2.00
not included)
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
3% Administrative Fee
TOTAL
~
$
$
$
$
<[~ .oU_
If'L::> _
----'~
'i(.~
40.00
40.00
20.00
36.00