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HomeMy WebLinkAboutPermit Electrical 1995-8-23 . SPRINclLO ,. 225 ,FIFTH STREET ' \"0 \o\\EU'l:nuCAL PERKIT APPLICATION SPRINGFIELD, OREGON 97477, D",\I.\8c1~\~s\,,(\cI\,'Se, qs I :)7 C; INSPECTION REQUEST: 726-3769 'ec\ "s s~\(e sl'cc, Ci ty Job Nlimber :::::. / OFFICE: . 726-3759 ,.\(\g I'IZ~ (\0\ lOCI . ,l,e \0\\0 enol clO ' PLETE FEE SCHEDULE BELOII 1. LOCATION OF I~STALLATI.~~~~~~\'. tfi'&, , Emerald Industrlal Electrlc S~9P~~?t . New Resident-ral-Single or , " 0 ~.::'A h,~t-t=Fa'mily per dwelling unit. LEGAL DESCRIPTION \)~-.lo..-D ( o'0\o~Service Included: ' 1919 Laura Street l'lns ;),7,;/;m;l'~ Items Cost Sum j...\.'i\\'~ JOB DESCRIPTION Installation of Alarm System 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 Electrical Contractor Emerald Ind. Electric Address 1919 Laura Street City Springfield Phone 747-8460 Supervisor Licen~e Number 1677S Expiration Date 10-01-95 Constr Contr. Number 63478!.'. Expiration Date , 1.'I:-26~9j= 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder : B. 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 $ 85.00 $ 15.00 $ 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 $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps ----- $ 80.00 Over 600 amps or 1000, volts see "B" above Branch Circuits Signature of Supervising Electrician :Jiv~;/ ~~ , .. Owners Name n ~ ,,~~D. ,~Sl Phone 7~7 -q71~ Address \ CJ \ 0 ,Cit,6.p~ , 01lNER INSTALLATION The installation is beitig made on property I own which is not intended for sale, lease or rent. Owners Signature: -----~------------------------------- DATE:O-23- qC; _ RECEIPT, t: U/6 /'1--,). RECEIVED BY: h-.J(1A.!" d /" New, Alteration or Extension Per Panel One Circuit 1 Each Additional Circuit or with Service or Feeder Permit $ 35.00 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 $ 36.60 5. SUBTOTAL OF ABOVE 5% 'State Surcharge TOTAL ' 3 ~ Abtt/41 --mTPL- 35.00 1'.75 -::t:.....;.:., I-OS; J1 37. gv ~