HomeMy WebLinkAboutPermit Electrical 1998-5-29
--~--
Q f u.- q V-F1I~, ' , 9 pro)ect88 submitted hesthe,followln
1/ -:P- 10 (/ zbf\in~ does n9t require apeciflcland use ,
apProval. \ ( ,
ZonInp (l; ,"
974<<QTIC~tlt;.~6 ELECTRICAL PERMIT APPLICAT~ON
72~..ro~'FT"'CVv'6'f\~~" Job Number qro /5 3
AUTHORIZED UNDER THI~ ~E~pfuM<ET FEE SCHEDULE BELOY
1. LOCATION OF INST4,Lr!i.9W1fNCED OR IS ABANDONED FOR '
!/;rJ:Jy . 1J~~ANY180DAYPER'nn, . A. New ~esid~ntial-Single.or
0., Multl-Famlly per dwelllng unit.
LEGAL DESCRIPTION Service Included:
/7 OJ- .30 ?~ 03/0lJ
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Sum
Cost
Items
$ 85.00 gs--
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Ser~ice or Feeder
JOB DESCRIPTION ..
'"
j..}.eu./ N~ 1d//rIVlC-
J
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is. suspended for
180 days.
I $ 15.00 /5-
.$ 40.00
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
, Installation, Alterations
Electrical Contractor~/(IJmJ BI!!ZrRlC.. or Relocation:
Address j?...C).. r3e?t s;Z? 4 'J
City ~ Phone ~rt:,- /fozR
Supervisor License Number ~(?fl1 ~
Expiration Date jc!J..- /-7~
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
200 amps or less
201 amps to 400 amps
~01 amps to 600 amps
601 am~s to 1000 amps
Over 1000 amps/volts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or, Relocation
Constr Contr. Number 011"" 3? 3
Expiration Date Ie:;. /- 9P
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
200 amp~'oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Signa ture of SUP~~v~Sing ?",;:,;:,;:,;:, ~['~
.~~
Owners Name 179m ~ (~"",.
Address "'::/;10S l~ &
Ci ty ~ Phone S1"S'- 3((/1
O\lNER.INSTALLATION
Branch Circuits
D.
,.
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 2.00.(
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
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
j~O,()O
s: 00
3. lJo
/ i)){.cJl}
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
--~----------1--,%' . --------------------
DATE: ~ 21 r %. /l ,
RECEIPT ft.: {() 00 f; 'f , 1/
RECEIVED BY: ~ W~