HomeMy WebLinkAboutPermit Electrical 1994-6-4
I
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zoning" and does not require specflc Ian
approval.
Zoninp ,
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
'Date
Authorized Signature
97477
726~3769
1. LOCATION OF INSTALLATION
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, ' ,
LEGAL DESCRIPTION ' '
'/.76>3 ~ 45 .I~9F')O
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JOB DESCRIPTION
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Permits are non-transferable and expire
if varkis not started within 180 days
af issuance ,arif vark is suspended far
180 days.
L-DL
tJM
ELECTRICAL PERMIT APPLICATION
,CityJo.b Number 9~O / S s;
3. COMPLETE FEE'SCHEDULE BELOV
A; Nev Residential-Single ar
Multi-Famiiy per dwelling unit.
Service Included: '
Items Cost
1000 sq.ft. or less
Each additional 500
sq; ft or portion
thereof
Each Manuf'dHome,cor
, -- MadularDwelling
Service or Feeder
, '
Sum
""----$ 85. pO
~~
.,c. $ 15.00
--6a~
$'40.00
2. CONTRACTOR INSTALLATION ONLY ,B. Services or F.eeders
, 'I' I /'h1 ~ J... ,(' Installatian, Alterations
Electrical contractof~bU.JZt."kr"EfuJ~r; Relacatia,n: .
Address ~ /6. s:, i'{)nif ~7, 200 amps or less
~.. " 201 amps to' 400 amps
Ci ty)dfU " Phone 7~7 /.-fJgy 401 amps to 600 amp_s
I ' 7 <f '7 617Cf '601 amps to. 1000 amps
Supervisar License Number '375 ~ ~ Over 1000 amps/volts
Recannect Only
Expiration Date lo.-9~
Canstr Cantr. Number7~O~~.
Expira tion Date 10-- 95
Signature af Supervising El~ctrician
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~Ju~IL,/p~)A..,!,"":~ ,"
'Owners Name (~,Ly4.lUf
Addre~s ~c>o '6 ~,. -s r
. . "
Ci ty ~~ Phone , 7~ - 6?1
OVNER INSTALLATION
The installation is ~eing madeQn
property I own which is not intended
for sale, lease or rent.
Ovners Signatllte:
----------------------~----------------
. ,- ..
DATE:
RECEIPT #:
RECEIVED BY:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. ' Temporary Services ar Feeders
Installation, Alteration or Relocation
200 amp~.aT less $ 40.00
201 amps to. 400 amps $ 55.00
Over 401 to 600 ,amps $ 80.00
Over 600 amps ar 1000 volts see "B" above
D.
Branch Circuits
,.
,New, Alter~tfon or Exten~ion Per Panel
,
,
\ " :
One Circuit
Each Additional
Citcuitorwith 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
E.
5~
SUBTOTAL OF ABOV~
5% State ~urcharge
3% Administrative Fee
TOTAL
$
$
$
$
/-:tc:tV
. 0
40.00
40.00
20.00
36.00
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