HomeMy WebLinkAboutPermit Electrical 1996-4-26
The following prcoje:::t as m.lbmi'ltoo.l:llr. th~ fQIIQwioQ
l,:min~;, ,-'\nd docs not require sp.eclflC !(l,ncllJa~
Gtppro.....ai.
Zoni~.J ,L D [L.
,J.,;'-2-1o-1 (P City 'Job Number Cf'00S?; J
Authortzad Signature J?VM.PLETE FEE SCHEDULE BELO'W
1. LOCATION OF IN~T4LLA^~ON .
--1.flJ (In!',(\T~n'\JY\.ln \ ~ 'L1!ntL. A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-37.:6:9a
OFFICE: 726-3759
ELECTRICAL PERMIT,APPLICATION
LEGAL DESCRIPTION
.1 'j ():tJ 2 (Pl/ L/ / c;tI tJ1)
Items
Cost
Sum
JOB DESCRIPTIQN . ., .
fun ~ Qf\0l(\D , Q M1( ,-L1-. ~ ~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
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
2. CONTRACTOR INSTALLATION ONLYB.
Electrical Contractod2 is POo.fl1lli1I~.
. ----, I
Address P.o,~. ,~g~
. ~ I
Ci tY.Jl~~ ~". Phon~ 141-"~~b
Supervisor License Number I b g h ~ .
Expiration Date ;0 - I-q g
, i'i~onstr Contr. Number ()r~~ i}q
Expiration Date q-I-qfo
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 I
$ 50.00 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amp~~r less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Signature of Supervising Electrician
.4~~
Owners Name \XD-u~ P.Pi\.r\.l.Y
Ad dress -.J ~/t Ll~Jtrn.m- ~ \}J) lnlu-at..
Ci t~\'f\~r ~ Lphone 11-.10- bbgq
O'WNER IN~ALLATION
D.
New, Alteration or Extension Per Panel
';,:,"
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit ~
$ 35.00
$ 2.00 4.0D
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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
5. SUBTOTAL OF ABOVE 5'4.00
5% S ta te Surcharge 1. '7()
3% Administrative Fee I. I/?/).....,
TOTAL 5'12. ~ 'l->
Owners Signature:
~~~~~----~/~-=q-~-------------~-----
RECEI PT #: L i.L,(") 1
RECEIVED BY: l/t:. '