HomeMy WebLinkAboutPermit Electrical 1995-4-17
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The followlrg project as $lIomM.€Id r:as the 1ollowm
zonrng and d06:J; not requIre speclf.c land use
approvc;11
225 FIITH STREET L-DL
SPRINGFIELD, OREGON 97477 Zontr,a
INSPECTION REQUEST: 72lP<6~hq+'1 -c;)'
OFFICE: 726-3759 II
Autnorlzed Slgnature~
J.
ELECTRICAL PERMIT APPLICATION
CHy Job Number
9~et:>4"V '5
::31;r~7R :'EE SCHEDULE BELOII
1- LOCATION OF INSTALLATION ~
3'5.t. ~ /" ~....u-'A;g; ~ A. New Residential-SIngle or
MultI-FamIly per dwellIng unI t.
LEG~ DESCRIe~N ServIce Included:
I _ tJ '//!J IJ f ()XJOO Items Cost Sum
J~ESCRIPTION \ lA:J, e( 1000 sq. ft. or less 1 $ 85 00 jG:
~ C:::;-fi!=-? Each addItIonal 500
sq. ft or portion ')/ ?;(), /'
Permits are non-traftsferable and expire thereof $ 15.00
if work IS not started wIthin 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular DwellIng
180 days. Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. ServIces or Feeders
Electrical Contractor~~1 r: 19(1'i-/? I C InstallatIon, AlteratIons
or Reloca 110n'
Address
Jd- Su..,'l.,v.d ,~+
Ci ty ;Y\~f<"r\~
Phone 47,'1-:11?-8
Supervisor License Number
/ n%C,
ExpiratIon Date IO-I--'1.s
Constr Contr. Number /r;?7LJ5
Expiration Date 9-4-15:
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Si~Jure of Supervising~lectrician
/ /~--1. C1? s./t;-AA/nAl~
-" v ,. - D
Owners Name~, tMt~fn:% ~.'
Address ~qQ hb ~ #r.
Ci ty ~tfJ Phone ,till-- lAf..ti!
~~ ~~TALLATION
The InstallatIon IS beIng made on
property I own WhICh IS not Intended
for sale, lease or rent.
Owners Signature:
---------------------7r-\~- -- - -------
DATE: <-t' \1 LD_
RECEIPr if: '-f~ I~
RECEIVED BY: l~U I
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C.
Temporary SerVIces or Feeders
InstallatIon, Alteratron 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 "B"
above
Branch CIrcUl ts
New, AlteratIon or ExtenSIon Per Panel
One C.1 n..Ul t
Each AddItIonal
CIrCUIt or with SerVIce
or Feeder PermIt
$ 35 OC
$ 2.00
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
:re'rnL ~
~
$ 40.00
$ 40 00
$ 20.00
$ 36.00
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