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HomeMy WebLinkAboutPermit Electrical 1995-10-13 -. e- SPRINGFIELD 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 Zoning 974 ?Qate 726,1\'~~.liged Signeture 1. LOCATION OF INSTALLATION 7b'5 N, A '9iR~E:T LEGAL DESCRIPTION JOB DESCRIPTION I ~"Y: I=,..,~ ofFiCe "RP:/V'OrJ/<.1 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 Address City Phone Supervisor License Number ~/)7~ S Expiration Date 10-/-113 I I Cons t r Con t r. Number ^' /A I Expiration Date Iv/.,A , : Signature of Supervising Electrician I ~nuiJ,1).~mdJ/l , , i Owners Name (";(/",,.,.,,.,1 ",,fIt" c:?...l::: OI57'RffT i Address h f?/l 1\). 3t. T1f I - i Ci ty SF'", t.Y.~I;:.t^ Phone...1Zt;-o/-,?~ I I OYNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: I rf'/flIAVd. D .2n7~g 1--------------------------------------- : DATE: .,{d'6<J /<7r ,RECEIPTli: ' /'7'..L rri-;z.- I RECEIVED BY: ~// ji:..( u_l /~' \ 3. ELECTRICAL PERIlIT APPLICATION City Job Number ',s7'~S2...... COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Sum Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling- Service or Feeder $ 85.00 $ 15.00 $ 40.00 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 $ 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 volts $ 40.00 $ 55.00 $ 80.00 see liB" above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit / Each Additional Circuit or with Service or Feeder Permit 3 -P' $ 35.00 %.00 $ Ii' . 2.00 b,DO E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ 36.00 -P~/,Ilt2 2-'{J5 1,23 ~4<t.2R 40.00 40.00 20.00