HomeMy WebLinkAboutPermit Electrical 1995-2-7
225 FIFTH STREET f I_VTV~TCAL PERMIT APPLICATION
7 ~fle follOWing prolect as submrtted has the 0 """"!l'U~
SPRINGFIELD, OREGON 9 4 G",or .\Inc' Joes not require specific land use
INSPECTION REQUEST: 72 p;l"Z&.lI /J CIty Job Number "'7 '5'"'"c:::>/~
OFFICE: 726-3759 I l)~
ZOning V ~ :3. COMPLETE FEE SCHEDULE BELOY
LOCATION OF INSTALLAJJON 2 ~ 7---"/=-
~ -:1 ...;,--, ~#'~~Cl!o<~-/-;)<
KY'-~w Res1dent1al-S1ngle or
llO1. U-rdOlLI.Y per dwell1ng un1 t
SerV1ce Included
1
\~6t.Ol~~,TION
D \fd.OO
JOB DESCRIPTION
A.J<~~
Perm1ts are non-transferable and exp1re
1f work 1S not started w1th1n 180 days
of 1ssuance or 1f work 1s-suspended for
180 days
2. CONTRACTOR INSTALLATION ONLY
Electncal Contractor _Al 15; Yl [:1 f,..-h;J I~
Address J.J... 010 -:zr.J '0,-/- ,
Clty /Y\2>dRA c;
Phone
Ylc;~~ 1'\9
InfJ(,5
SuperV1sor L1cense Number
Expnat10n Date
lD-l-q:::;
Constr Contr Number Ic?lLJ.:';
ExpHatlon Date Q-LJ -qs
S1gnature of super~1ng Electr1c1an
t:?JLe.L'/ - 4A ---' --:'~-^
Owners Nam~ ~ ItOOf\ mh.
Address ~qt1 ~ (~?nd
C1 ty ~.tl Phone l44-ld1.lda.
OWNE~llNSTALLATION
The 1nstallat1on lS be1ng made on
property I own Wh1Ch 1S not 1ntended
for sale, lease or rent
Owners Slgnature.
~ATE-------------Jl~'1-~~----------
RECEIPT It., \~_::-.., \}I4:\-I I .
RECEIVED BY: U 1)..J
'-
1000 sq ft or less
Each addItIonal 500
sq ft or port1on
thereof
Each Manuf'd Home or
Modular Dwel11ng
SerV1ce or Feeder
B. Serv1ces or Feeders
InstallatIon, Alterat10ns
or Relocat1on'
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
Items
Cost Sum
$ 85 00 &
$ 15 00 &l
$ 40 00
I
c9-
$ 50 00
$ 60 00
$100 00
$130 00
$300 00
$ 40.00
C
Temporary Serv1ces or Feeders
Installat1on, Alterat10n or Relocat1on
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch CIrcuIts
New, Alterat10n or Extens10n Per Panel
$ 35 00
One C,rcu,t
Each Add1 tlOnal
C1rcu1t or w1th Serv1ce
or Feeder Perm1t
$ 40 00
$ 55 00
$ 80 00
volts see liB" above
$ 2 00
no t 1ncluded)
M1scellaneous (Serv1ce/feeder
-Each Installat10n
Pump or 1rr1gat1on
Slgn/Outl1ne L1ght1ng
L1m1ted Energy/Res
L1m1ted Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Adm1n1strat1ve Fee
TOTAL
$
$
$
$
115.00
~~
~~ -1/;-
40.00
40 00
20.00
36.00