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HomeMy WebLinkAboutPermit Electrical 1996-2-27 ." -. J.. ,.' ~ zoning, and does not requlro spoclflc land use ""~'vn;lJ/V D.t~~ '~ 225 FIFTH STREET Authorized Signature .,a...,/) ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ~ INSPECTION REQUEST: 726-3769 City'Job Number Qc;.dC?("P OFFICE: 726-3759 1. 3. LOCATION OF INSTALLATIOE/ ?....../ ~ / A .zu,ZS- ! :t.~l. 7 5. UAV~~, A. LEGAL DESCRIPTION...,I /7/)'1, 22.. 3.,.. &L);un.::; JOB Dr;SCRIPTION }!/yJU-x Permits are non-transferable and expire if ~ork is not started ~ithin 180 days of issuance or if ~ork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY B. Electrical' Contractor L ~ C E~)ck:, Address 41o? JE'55t7.<t) M, Ci ty ~,~ Phone ~q, - <(,c)~7 Supervisor License Number -f./ 74-5 /c)///5'S Conser Contr. Number /(9 ",-.;r?', Expiration Date Expiration Date .7-.JD-7'i:D Signature of Supervising Electrician LAurr:UfO ~' ~~ufloJ.\ O~ners Name pyur ~b,t?.r Address Ci ty Phone '7~& -/S-2. 1 OVNER INSTALLATION The installation is being made on property I o~n ~hich is not intended for sale, lease or rent. COMPLETE FEE SCHEDULE BELOY Ne~ Residential-Single or Multi-Family per d~elling unit. Service Included: !'tems Cost Sum 1000 sq.ft. or less 2- $ 85.00 /70 Each additional 500 sq. ft or portion thereof ...2.:.... ."$ 15.00 :5 '0 Each Manuf'd Home. or Modular 'D~elling Service or Feeder $ 40.00 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL S 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation $ 40.00 $ 55.00 S 80.00 see UBI! above New, Alteration or Extension Per Panel S 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 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 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits Ovners Signature: ~~~~~~--~---~-~~to----=----- RECEIPT If: \ l'-I\",-' \ -.rJ.....\L\ RECEIVED BY: ~~ rI\l}l\ One Circuit Each Additional Circuit or with Service or Feeder Permit ? /.)r)J.'/J / /J 00 b, 00 ? ((. C/D