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HomeMy WebLinkAboutPermit Electrical 1995-6-28 r"" fo!lowing project .. oubmltted has the following ,. . : .j, and do.. not require epeel!lc land uee t:p!':',i"al. Zoning 1./ D l2-- 225 FIFTH STREET (;~",It"'L(>I1..( SPRINGFIELD, OREGON 97471 N INSPECfION REQUEST: l\]'2~~~~gnalure jV\.. OFFICE: 726-3759 1. LOCATION OF IN. STALLATION A -?_tfi2. ~ 1 d~a- ~~ /to LEGAL DESCRIPTION -/7~.~ 2-2- .,z/ CJ5''7~;z;;;, JOB DESCRIPTION //.9~- Ct~';>A../~ ELECTRICAL PERMIT APPLICATION :: ty Job Number q c::;--/ CJ 77' 3. COMPLETE FEE SCHEDULE BELOV ~ - 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 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. CONTRACfOR INSTALLATION ONLY Electrical ContPactor.~ J\JO~.~~ Address / /J /2 ,<)/~AL~ LJ) . - I ' Ci ty_ j:;T./c; . Phone ~ - 72. J / super~'fl"L'i~ns~~ ds,'? L~ , Expiration Date /r,/9.J Constr Contr.Number o/91-tJ39 ?/2. ~~>'r:- \~suP~it~1~~2d;- "owners -;:me ~~~. CL/d Address U 362-- LlIP/1 A-- Sr; Ci ty J ~ ~ . ,..,.,. ~ne f 'Yo )1'7 ?..,,{J!id ~-- t::J+. -, T OVNER INSTALLATION Expiration Date 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 5_ SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 55.00 $ 80.00 see nB" above New, Alteration or Extension Per Panel .' One Circuit ~ $ 35.00 ~ Each Additional Circuit or with Service or Feeder Permit $ 2.00 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 $ 36.00 200 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 D. Branch Circuits The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~~~-:~----~~;C~~.~~_~~~-;------- RECEIVED BY: ~........ "?c::; 01) i. '7..r /_~< ,~ ;7, lI,C!