HomeMy WebLinkAboutPermit Electrical 1995-7-20
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225 FIFTH STREET approval. 17 ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonina L-Diy- CI'.
INSPECTION REQUEST: 726-3769 in,~)' Ci ty Job Number _/ '5/J53%
OFFICE: 726-3759 Dat"~// -/ ,I'
1. LO<;AJION OF INSTAL0;ti(f~od Sign.lur. \'I MJ. COMPLETE FEE SCHEDULE BELOY
/.:59b //#c sr: A. New Residential-Single or
Multi-Family per dwelling unit.
) >(3~ DEmPT~ I q(J"C(' Service Included: Items Cost
Sum
$ 85.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Mod.ular.. Dwelling
Service or Feeder
JOB DESCRIPTION
-r&.#JP &Ed7/t'SMvlt:&
$ 15.00; "
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. CONTRACTOR INSTALLATION ONLY
'.
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
B.
Electrical Contractor _ ~~~ t'~ ~;>-
Address ;P.p..d?.A' ,2,31:5"1/
Ci ty E.IIU#t:- Phone 3~9' ~;t.f'
$ 50.00' "
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Supervisor License Number ~~~~
Expiration Date //J~/~95
Constr Contr. Number~
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00 4/).//t')
$ 55.00
$ 80.00
see liB" above
200 amps or less )(
201 amps to 400 amps'
Over 401 to 600 amps
Over 600 amps or 1000 volts
-5'-/6-96
Expiration Date
Branch circuits
D.
Owners H;J .&/?--I~
Address 747 p. s~/
Ci t~O.vU'JdI~(IJ'hone /2.. (/ - ()Is 7
O1iNER IN~LATI~N
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
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
5. SUBTOTAL OF ABOVE ~p.Ot'
5% State Surcharge ~.;;Z"'~2.YJl
3% Administrative Fee
TOTAL
The installation is being made on
property I own which is not intended
for sale, lease or rent.
"
Owners Signature:
----~--~----- . ------------------
DATE:L~ vO ~ 'j'J
RECEIPT jI: 0/9;5 K') _
RECEIVED BY: ~~,..-.
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