HomeMy WebLinkAboutPermit Electrical 1995-7-3
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The following prole , , I
zoning, and does not require speclflc land use.
approval. ' . I
225 FIFTH STREET ' Zonina L,.-J) f2.- IELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 974]7 ""'_~.-'~I{' I 'q~\\N
INSPECTION REQUEST: 72~~}16'j 'rJ IV\. ,City Job Number \...) 1),.1)
OFFICE: 726-3759 Authorized Signature : . ' ..
1(1 3. COMPLETE FEE SCHEDULE BELOY
,1. LQCA'JU<1N OF INSTALLATION, I
J /59 W. Cenki'd\ Ie; I A. New Residential-Single or
'1-10-:l..f\...i-y1/IfY"\VY'JMulti~FamilY per dwelling unit.
LEGAL DESCRIPTION I ~O\ I \ ,l'\..UL.)J Servide Included:
1.)' )ptpy Rp<;c\.eJ\.L..f' Items
JQB DESCRIPTION .. 1000 sq. ft. or less
Rp~trJP ~r-~M ' R\5etS ,+ Fee(.\6:5 Each ~ddi tional 500
\ /' I .. sq. it or portion
Permits are non-transferable and expire ther+of .
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for ModuiarDwelling
180 days. ' service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. serv~~es or Feeders
Installation, Alterations
Electrical Contractor br}\CL.. 8Q.cl-~c- 6\1(:.. or Relocation:
Address \ '850 R~\"l f'...C S""" 200 afPs or less Z $ 50.00 ,IOn DO '
~ 201 amps to 400 amps $ 60.00
Ci ty \:::;);jC')E?.t-..P," Phone 40[- 00(;" ( 401 arps to, 600 amps $100.00
~ 601 amps to 1000 amps $130.00
Supervisor License Number 3C\ l '2-. S Over :1000 amps/volts $300.00
I
O / Recon.nec t Only $ 40.00
Expiration Date /0 0/ ate; j ,
! C. Temp~rary Services or Feeders
Constr Contr. Number<-~' 9-,x03 Installation, Alteration or Relocation
I
Expiration Date :~128/ q(_ 200 ~mps
{ , ( , 201 amps
Signature of Supervising Electrician Over 1401
r \). Over '600
1.4 f)~ .-Xl')J.J1:7Vv'--'l.
or less
to 400 amps
to 600 amps
amps or 1000
s'\ ~ c.._ i'-.' S G tf'.
D.
Branch Circuits
Owners Name r~U ,1---\.
Address 1~5() Ke5\(V"A./ ~'i;',
Ci ty \. , t] 'P/V"-l'" Phone L; C,I-(Xl;, /
OVNER INSTALLATION
,.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
, One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00 '
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
The installation is being made on.
property I own which is not intended
~or sale, lease or rent.
E.
OvnersSignature:
DATE~------;----~I)~~-~' ----,--
RECEIPT #: U I f\ t =i~
RECEIVED BY() )tiJ (l) ..
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
,.
$
$
$
$
/no, on
, c:: 00
3: () 6 '
Ir\ (\ Dr')
40.00
40.00
20.00
36.00