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HomeMy WebLinkAboutPermit Electrical 1995-3-23 . . 225 FIFTH STREET ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 City Job Number OFFICE: 726-3759 ( ~ 1. A rp~gION ~ lNSTALLA!ION ~(Jl 0 . \(\ ~ N\ \ r-..~ LEGAL DESCRIFTION /~~ t"'J r 2...1 (!) '1 Q vt;..L _~ JOB DESCRlPTION o ('! lLC!J..y ~ ) 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 contract~~ \A.g,{'~ <(10,,1- AddreSSm '9'1\ ~ffi\.~ City<c.. 'Y~I\O Phone~<6.CA~a . Supervisor icelise Number .ff\C') (")~ Expiration Date 'l~, \.~:=1 Constr Contr. Number_C'f\2....C;..J 0 Expiration Date \ ~ . \0 .CJf\. Signature of Supervising Electrician ~.P~~' Owners NameJ'<\o.JtJq ,--,\~u~ Address ~()l 0 ~cJ. N\l 0...... City we Q lJ\.Q "' Phone OVNER It~TALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners' Signature: ------------------;.:-------------------- DATE: Z/J. ), /, [ RECEIPT j1: -. //.,'2/;J.. RECEIVED B'y: ~ /"'7;;.A.. 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less $ 85.00. Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 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 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above Branch Ci rcuits .' New, Alteration or Extension Per Panel One Circui t Each Additional Circuit or with Service or Feeder Permit $ 35.00 65 $ 2.00 d.. E. . Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ ?-l\ .ci) I.~ ;:J'.~~ 40.00 40.00 20.00 36.00