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HomeMy WebLinkAboutPermit Electrical 1997-12-3 . 4'o)} ~.S' ~~ Af'& ~ ~" Co ~ ~-21 ' "i'1I. Q% ~~ ';~~:I' ELECTRICAL PERMIT APPLICATION .v;, ,(('~ ~O ~<. "6'00 0-0 &1-0.... (~~ City Job Number Or 7 I ~ cr (e( "'I;, 009 ~~ ~09..0..._ 'o~/,l 3:r-1, ~wo;~ FEE SCHEDULE BELOII '?:il) O>Af'o1/. ..0,.<:: ~ . 'A. N't% R~dfIiMal-Single or Mul~F{~t~~r dwelling unit. Servi~li{l(jl)lded : ~ Items Cost 'Zoning , C/U Dall) -.J "q"1- Authorlzod Signature n YI\J 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 LOCATION OF INSTALj;ION ?,l, q ~ 1jJ/4rV1 P'7rP..4ft1 . , LEGAL DESCRIPTION ~( 0 0 t!J 1703/~3'3, ()..-/.Q 1. JOB DESCRIPTION IJ,SU/~. f/}W{-;1?~ FEt). 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 Llffi ~/L. Address ,"0_ City ~./b, fllYJ Phone ,/7.. "'/ -c;qi? J '3 S 5' 35 10 - "U Cons tr Con tr. Number --z. [} /:2-8-&-C/ Expiration Date ~ 5 -4 g Supervisor License Number Expiration Date Signature of Supervising Electrician 4;. /4:J~ v D. Owners Name lA S Cu u y-- Address City Phone OIINER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: 3;;iD nq_M ~ A c; 7 RECEIPT ':, ' ~l,{ I'SGJ RECEIVED BY: ~ ,) , 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: Sum $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 c;o'!3- 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 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 100U volts Branch Circuits $ 40.00 $ 55.00 $ 80.00 see "B" above .' New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40,00 Sign/Outline Lightin~ $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE $f: 60, - 5% State Surcharge .~ ~,Sl' 3% Adminis tra ti ve Fee '$ /. s-z> TOTAL 19.h d, - r,