HomeMy WebLinkAboutPermit Electrical 1995-3-13
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225 FIFTH STREET ape"".i.. tV ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 97477 ZO",M oa /
INSPECTION REQUEST: 726-37~. 3A:'-'l5 City Job Number C14.0 O/1,.c1
OFFICE: 726-3759 II
Autho'lzed Signature J. rv ~P:E:'.n F...E SCHEDULE BEr:oV
1. LOCATIlW OF INSTALLATION _1... ../,/j
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LEGAL DESCRIPTION
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JOB DESCRIPTION .J'l5"
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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~ g,,~cJ-.tf,lz./
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Addressa?tJ41#.,4A1hu ;11:
City~(1,<'/}~ PhoneS1-2~/r~9
J ~3.Y .r
Supervisor License Number ,;l.., --J I:"."~
Expiration Date ~~
Constr Contr. Number 64~/J1
Expiration Date 13A.,
Signature of Supervising Electrician
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Owners Name t:;......-IU ~~t2/JC~. D.
Address //~"pr.::4.zIuJtf IX~
Ci ty o//d. Phone 1-.#t- ~ ;.f'f~
OIlNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:. 3. - G.. -q I)
RECEIPl iF:. {'nr:::;lrC]
RECEIVED BY: . - (~
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B.
Services or Feeders
Installation, Alterations
or Relocation:
$ 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
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 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 Lighting.1- $ 40.00 ~
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE "t?~l?
5% S ta te Surcharge .:;. blJ
3% Administrative Fee .I. ;/d
TOTAL ~#'. :zo