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HomeMy WebLinkAboutPermit Electrical 1994-4-20 ~. SPRING.~ The following project as submitted has the following 225 FIFTH STREET ~onl;;'~ar.nd does not requir pecKle land usa ELECTRICAL PERKIT APPLICATION SPRINGFIELD, OREGON 97471 n I r INSPECTION REQUEST: 726-3~69'n}\' Ci ty Job Number VI '10337 OFFICE: 726-3759 'Dffie, i COMPLETE FEE SCHEDULE BELOV 1. LOCATION OF INSTALIiA,Ir.lPNld Signature .zt.<I'" S. c.lenlN"kQ.r A. New Residential-Single or Hulti-Family per dwelling unit. Service Included: , LEGAL DESCRIPTION ~~/'i, Z9~, Z2,T.J7.s.JG3.1lJ~, kJ.M, $/"'1;1 7e/~ ~~ a",/ Ot'€, - f\' OB DESCRIrrI~-'1-;- \ .1) j\ Q .~l:'. \).A.I \ k Permits a~ n-transfe~ble and expire if work is ot started within 180 days .of issuance or if work is suspended for 180 days. ! 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor~~ ~~~/' Address qg') ~1tP 1 City 6:1,,(~;f\L Phone ,,~-g7~ Supervisor Licen.se Number .1....efoo c::::::: Expiration Date " Constr Contr. Number z.r..bzif0-('?~? Expira_tion Date (.,.-/0- 9''1 . Sl~~.~"i.i" Owners Nam:iJ:,;.t I3I~jr'" Address'1'!Oz. Te-n:t/et! /r1. Ci ty e.~ Phone "B'i"-5"'2-7"- OVNER INSTALLATION The installation is behig made on property I own which is not intended for sale, lease or rent. OWners Signature: ~ DATE:------y;~.;;.-=---~---------- RECEJ.r1 i~ /~,.,., ~ #../ -- ".-.J..;. RECEIVED B}: ....--- /::.-....,..____ '/f-' r .: It ems Cost Sum 1000 sq.ft. or less I $ 85.00 ~ Each additional 500 sq. ft or portion $ ~ thereof $ 15.00 Each Hanuf'd Home or Hodular Dwelling Service or Feeder $ 40.00 . , B. Services or Feeders Installation, Alterations or Relocatio.n: 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 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 D. Branch Circuits ---- ~ $ 40.00 $ 55.00 $ 80.00 see nB" volts above New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 not included) Hiscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ $ $ $ ~/~ _J ~ ~ ~-_ - /e>.'fi'!> -d' "=" '-'11\::__ 40.00 40.00 20.00 36.00 ",I ?, :::t?V5