HomeMy WebLinkAboutPermit Electrical 1995-12-5
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SPRIN!ELD
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225 FIFTH STREET D~e \ 2... s- '15 ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ~
INSPECTION REOUEST: 726_37&9.>t",ori2edSlgn&IUre r \. (;ity Job Number 95 - 1(P5:~
OFFICE: 72~-3759
1. LOCATION OF INSTALLATION
J./., ~ "7 A/oJVn../ II A." .57".
\f)n~PTI?J:f}r[)
JOB D~~PTION .
A-11O ((,,)-- iBntA.-Ju../ Cltt'-I/ITS
, ,
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
\
Electrical Contractor p~\~~
~~^-.J
~l(.;
bc-VD
Address 2- ( 2-1
Ci ty eVf::1 ESrv~
Phone ?<t::. -74:<.i:'L
Supervisor License Number .;;27 ~ -oS
10 - I - 7~ ..
Constr Contr. Number .~... ::i)"Z-rJ
J./-I5'" - '75'"
Expiration Date
Ci ty 11..eIt'!/~ 1111...1.. Phone
br. '17'1S!::'
01lNER INSTALLATION
The installation is. being made on
. property I own which is not intended
for sale, lease or rent.
Owners Signature:
tt1"r --- . .
DATE~------------:- ~-~~. --~---
RECEIPT II: I I W.J.c)
RECEIVED BY: (2)1>>-:-;: \ r'..::..
3. COHPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per'dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
It ems Cos t
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or.Feeders
Installation, Alteration or RelocatioA
or less
to 4'00 amps
to 600 amps
amps or 1000
volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
Expiration Date 200 amps
.. 201 amps
Signature of su~er 1 'n E~ectri . Over 401
. /? Over 600
'JP.. / ,.- . ~ -P...k'-" ___
... ~ D. Branch Circuits
Owners ~a:e Me ~/~;/(/e'n -Atno
Address f?f), ~ox &40
JfX'U ~ &'7,.,1.;""
New, Alteration or Extension Per Panel
One Circuit / $ 35.00 .3.~
Each Additional
Circuit or with Service
or Feeder Permit 5 $.2.00. 10 ~
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
TOTAL
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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