HomeMy WebLinkAboutPermit Electrical 1996-2-27
The following project as liubmit!ad hao the iollow!.
zoning, and does no! requlro spoclflc land uS<)
approval. '. . /7 L:J
Zonina. '-?'YJ ~ /\....-/
225 FIFTH STREET Dot" D2;ie:J7/'Jt/
SPRINGFIELD, OREGON 9747r7uthorizadSIgnaturo ~
INSPECTION REQUEST: 726-3769 . /
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
2h:,~7' (26.11 S. Cll1vM~L/).
LEGAL DESCRIPTION
/7t'J.3 22- ,.o;G ~/6)'D
JOB DESCRIPTION
711./ fiYL. ~
Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended ,for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical ,Contractor L -rE.
Address LI/()~
Ci ty f\ ':qo~
\
E&dnt. 7'1'1(,
, r ~<;OY\ tt-
Phone ls88 - qoS,?
Lf(f Lf-5
lo/l/qt::,
.
Supervisor License Number
Expiration Date
,
Cons tr Con t r. Number / I? ft} -47 S
Expiration Date
,( - ~ n - 9 r":..
Signature of Supervising Electrician
.1l'{Y"J/I/_Q _, . ~lA OJ",
Oyners Name PY~T ~F~,-
Address
City Phone
7U -/Cz..l
.
OVNER INSTALLATION
The installation is being made on
property I oyn yhich is not intended
for sale, lease or rent.
City Job Number
ELECTRICAL PERMIT APPLICATION
3. COMPLETE FEE SCHEDULE BELOII
q .f"! 7i"j'
A. Ney Residential-Single or
Multi-Family per dyelling unit.
Service Included:
Items Cos t
Sum
1000 sq. ft. or less 2 $ 85.00 LZQ
Each additional 500
sq. ft or portion
thereof ~ '$ 15.00 S~
Each Manuf'd Home. or
Modular 'Dyelling
Service or Feeder $ 40.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 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
$ 80.00
see "Bit above
New, Alteration or Extension Per Panel
$ 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
,B.
Services or Feeders
Installation, Alterations
or Relocation:
Owners Signature:
~~~E~---------------------iCl~'\~--
RECEIPT n: ,Jt I':) \ y. ,
RECEIVED BY: . -i V J'''\~ .
U \ WtAI
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
One Circuit
Each Additional
Circuit or yith Service
or Feeder Permit
2L7Opo
/O~
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