HomeMy WebLinkAboutPermit Electrical 1996-6-10
.
i . ",::. '~"'~ p{~'.l1JCl as submitted has the folio
l.....ilIlg. a.nd does not require specific land UN
approval. ~;."
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Zoning L t> t-
97477
726-~'16-9.lD' LO . q (0
Authorlzed Slgnalure---1!0
ELECTRICAL PERMIT APPLICATION
City Job Number Q l olli ~S
1. t9~T?0~OF ~~01ALLA~t
l 'frIb.D~:!fg;l OJ] 00
~eB\ttrnn6nC'-L.. Q. ~(f)
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
,2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor~ ~r~
Address gqcVl("'""D:1y Lane J
City f.l)q~e.; Phone (d3c:,~OqO.s
~
Supervisor License Number 15~ '0 S
IO/IJq~
5#3/
Q/!30/Qe
. .
Expiration Date
Constr Contr. Number
Expiration Date
signatur~pervising Electrician
(/(/~~a
Owners NameJ;.t.Ql\\)
Address \ \~ fr Xiv ~ nit
Ci ty f \ Y\Q.110 Phone].1 q .q I b l
OVNER-'I~TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: C-c.~'7~
RECEIPT if: 'ZJ{K/~
RECEIVED BY: /' .L ~_ .
'p
3~~~~~, ~ SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items
1000 sq.ft. or less l
~ Each addi tional 500
sq. ft or portion 4
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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
Cost Sum
$ 85.00 <5
$ 15.00 lob
$ 40.00
$ 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 volts
D.
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 40.00 '~~.~
$ 55.00
$ 80.00
see "Bn above
$ 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
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
I ,
./-...~ ~lQ
~ .AS'--
4.J~
IS 5:'C40
"J. '25'
5775'
- -
199 $0
I..&t.l.e
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