HomeMy WebLinkAboutPermit Electrical 1997-4-21
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The following project as submitted hos tho following
zoning, and does not require speciilc lund u~o
approval.
225 FIFTH STREET . I ~,() ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ZOning L-.LJ \.......... 9 .
INSPECTION REOUEST: 726T..~7369J..,J/?I!i1-4/Yl City Job Number 70303
OFPICE: 726-3759' .
Authorized SI!jnature C:OHIiiITE.EEE SCIlEDULE DELOII
~Q.C@'I~OP ,Il;lliTALLATIQN .
.:-,~ ~'7' .~4Z EJ...DtR.f)~ A. New Residential-Single or
Multi-Family per dwelling unit.
LEGAL DESCRIPTION; Service Included:
/R'IJ') O'+'..J. (){j300 Items Cost Sum
JOB DESCRIPTION lOOO..sq. ft. or less $ 85.00
SDD + /ftDrrtJiZ.J Each addi tional 500
sq. ft or portion
Permits are non-transferable and expire thereof $ 15.00
if work is not started within' 180 days Each Manuf'd Home. or
of issuance or if "ork is suspended for Modular. 'Dwelling
180 days. Service or Feeder S 40.00
.B. 'Services or Feeders
Installation, Alterations
or Relocation:
2.' CONTRACTOR INSTALLATION ONLY
Electrical contractor'Df4Y\ .f]eilrl~
Address /150 fuk~~ 4fz4,
City r::/f/Y8Ie.. . J..one6ll/7~t./1.f s:i1S-
. J f ,~
Supervisor License Number .:5k 1e;:5
Expiration Date /D-/-Cj'&'
Constr ContI.'. Number . ~(ll14,4 ,/
~-2:3-% q?-
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
S 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 1000
Expiration Date
f.
Signature of Supervising Electrician
'~DC '.
Owner}JName [(0.haU:::>iJ /'0110
Address7'!~/2.- el~&~r91 ST
Cit~a- Phone '72-c- . 'l?L-Lf<),
01lNER INSTALLATION
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
, "
"
New, Altc!,:'ation or Extension Per Panel
1
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
Circuit or "ith Service
or Feeder Permit
'\
The installation is being made on
property I own "hieh is not intended
for sale, lease or rent.
E.
Owners Signature:
DATE~-~~-~~-~~--------------------
RECEIPT. .:r 1.1 '\ ::?K \e>
RECEIVED BY:fl . lY161cAa..d 0
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
--1- $ 35.00 .<,C;::tIO
"
$
2.00 !'6.2f)
'. . ~
not included)
. .
$ 40.00
S 40.00
S 20.00
S 36.00'
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