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HomeMy WebLinkAboutPermit Electrical 1994-12-9 . , 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 l,t'J . 1. .'LOCATION OF INSTALLATIQ!i... '1 ;Z lTb <J)/Y'~~ J),e, City Job Number ELECTRICAL PERMIT APPLICATION t1~ \ f)49J , 3. COMPLETE FEE SCHEDULE BELOV , A. New Residential-Single or Multi-Family per dwelling ~it. Service Included: \~CYlfJ~ON(f)C?t'X) ~ Uoqg- J}lB DESCRIPTION JJ}i;./'/..) <J;::2 Permi ts are non- transferable and expi're if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor (:\ ~\'td I='J,rtf.&k." Address I:::l. ~\U ~~ >"-\0.-. C i t Y rI\ r-Av..s. Phone ~C;-,JJ <.q_ Supervisor License Number _1~fY^ S Expiration Date I D-I-ql/ Cons t r Con tr. Number I C1 '?--l4-~ Expiration Date Cl-L-.J-t15 a}Lf ~::;:t2cian Owners NameI.lA~A/ zrA.77:' -L'~ ., - , Address "l?'f'9 ? ~=12_~ Ci ty ~b,. Phone /L)~...,{" ~~ OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: .' ~~~~:~-:~----~ I ~ P? 1~~---:-~-- REC,EIVED BY: ~. '(:Jjti~i...) - Items Cost Sum 1000 sq.ft. or less \ ~ 85.00 fI; Each additional 500 sq. ft or portion 1- ~ thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 B. Services or Feeders Installation, Alterations 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 $ 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 Over 401 to 600 amps Over 600 amps or 100u volts D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 see "B" above New, 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 with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 35.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 US CO t:; "J ~_ ,3 ft...... j~4 . ?IJ