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HomeMy WebLinkAboutPermit Electrical 1995-9-14 JI"= .... .. . . c\ e..,n ~\\'t':l":",.:i"(', IJ..-"~' jtl..,; ~()~\OVJ'f'\\, PTOlrl . q"i~;l:~ 9p\.~liIC land us ". .. a"'6'~ not rl;l ... I "on,';I..j., U;l'J ..J:,J -;'pproval.. {J L 0 97477 ZOning 726-3768.'0 C) I ~5 Ci ty Jo~ Number -=::::n~Le s ~ ' Authorized Signa ~ . OHPLETE FEE SCHEDULE BELOV 1. LOCATION OF INSTALLATION 3-:2t'l i=O,'rv.-PuJ 225 FIFTH STREET SPRINGFIELD, OREGON ,INSPECTION REQUEST: OFFICE: 726-3759 LEGAL DESCRIPTION /-?/J? 2.., -;// c:o /1")/ JOB DESCRIPTION insfa./I ~<;,p('/~ Permits are non-transferable and expire if ~ork is not started ~ithin 180 days of issuance or if ~ork is suspended for 180 days. ~ ELECTRICAL PERKIT APPLICATION A. Ne~ Residential-Single or Multi-Family per d~elling Service Included: Qr;'/~!!J 9 , , uni t. It ems Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations Electrical Contractor,Sonitrol Security or Relocation: \ Address P.O. Box 21009 City Euuene Phone 461-5678 Supervisor License Number /t,gc; Ref Expiration Date /tJ-/- 9?, 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 Constr Contr. Number 65149 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date 6-28-96 Signature of Supervising Electrician '/r;;..~~./ _ ' f) D. O~ners Name l-lfadSfa"/:ftlF J...unp. Lo Address .5::un1? Ci ty Phone ;F-/7-;;J'fd5 OVNER INSTALLATION 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts Branch Circuits S 40.00 S 55.00 $ 80.00 see "B" above Ne~, 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 $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 ~ The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: ---------------7---T~---------------- DATE: i. J~( 5'S RECEIPT #: { /~~..,"Q RECEIVED BY: / ,;,!7~ ~ . ~ ,1"... 1 - 1 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL ~%.O{J (, )?t'J l.JJx- -3'i? S?X