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HomeMy WebLinkAboutPermit Electrical 1996-7-8 r' 225 FIFTII STREET SPRINGFIELD, OREGON 97477 /') I "'I c::' INSPECTION REQUEST: 726-3769 Ci ty Job Number ~l. O() S 1~ OFFICE: 726-3759 1. LOCATION OF INSTALLATION 2 730 ~A-r-.e'WA-Y 57" LEGAL DESCRIPTION 17-0~- 2-2- -00 102- 'c:>S- JOB DESCRIPTION 71:1HP. iElb:.. .>>'<V<c:- ,.tQrl. ~".o.nrCtTY 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 )J'-IJj,et!rT1!::llf) ($"/...c. Address 3 BY W. -t,,4 Ci ty EL.J ~e-.Jl:'". /).<. Phone----Zvt/-S.r9--i Supervisor License Number J]J~ S Expiration Date /o-,/-9S' Constr Contr. Number ~~32-s")'" Expiration Date /-1'- 97 Signature of Supervising Electrician ~ ;{'lftc~" Ovners Nale' C/~/T tJ/7'y ,~A!".;,s- Address Q9.rfJ Allt-ytAA.JI' ];>1- . K'c.I'I-",O Cl ty ./l1l. ~/AJ/~ Phone OYNER INSTALLATION The installation is being made on property I ovn vhich is not intended for saie, lease or rent. Owners Signature: ~~~~~--~-~-~-~~~~-------~----- RECEIPT #: .n:=:t \""3 ..,. 9: . RECEIVED BY: -. - -J\..- ~r'1 / ~ \J 3. COMPLETE FEE SCHEDULE BELOV A. Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items Cost SU:;j 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 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 $' 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 -L $ 40.00 y'd ..~ 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80,00 Over 600 amps or 1000 volts see "B" 'above D. Branch Circuits Nev, Alteration or Extension Per Panel One Circui t Each Additional Circuit or \lith Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) $ 40.00 $ 40.00 $ 20.00 S 36.00 5. yo ow V ;V~~ 3~o . \. ~O '-I ? ,~() SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ~