HomeMy WebLinkAboutPermit Electrical 1996-12-31
~
225 ,FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
J~1l^~~N ~~QrrAION ~-f/01
LEGAL DESCRIPTI~ .
\ <;<,()7 nt ~ .\
<l ,lOJ1....DESCRIPTI~N
<"),, '&.,0\ rt n n~..'u
\loCl~
..
Permits are non-traftsferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.'
.
City Job Number
, ..
ELECTRICAL PERMIT APPLICATION
C\ 5fJl""l ~
3. COHPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
, ,., .: <,:- I. ~i
, , ..-.. anl(does not roqUlro ~ ,,^-,lllV ,..."...--
zoning,
approval.
Zonir19_L.J2('V
9~ig'3769ibl~Wt
Acthorize-:l Signa\Uro_ \J ~
Items
1000 sq.ft. or less I
Each additional 500
sq. ft or portion n
thereof , 0-.
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Allen Electric or Relocation:
Address
12 SW 3rd SI:..
City M"dr"",
Phone 475-2139
Supervisor License Number 10065
Expiration Date
10-1-95
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Constr Contr. Number 6R74~
Expiration Date
9-4-95
Signature of Supervising Electrician
..-4? ~<"( . ~ /yY'L.a-6-...-.
Ollners Nam~ @:-tG1""
Address ~qq ~(j oW g.r
City ~~rl_ Phone-=:144..1~
OWER I}lsTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
--...-------------------qr:-------------
DA'l'E: \.~.;\. V ~
RECEIP1' 11: . I
RECEIvED BY: '(N/j~ ..~
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
unit.
Cost Sum
$ 85.00 ,&5
$ 15.00 3)
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see IIB" above
Nell, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or Ilith Service
or Feeder Permit
E.
5.
SU,BTOTAL OF ABOVE
5% State Surcharge
wm. ..3%
-rot-oJ---
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
IIS.co
15. /.....,
.~ :<K"
Icti.W