HomeMy WebLinkAboutPermit Electrical 1995-8-8
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225 FIFTH STREET apI"IOV"', CDfZ- ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonino fA 6
INSPECfION REQUEST: 7i\~,'Y3769 '&--~ --'19 City Job Number -,513/
OFFICE: 726-3759 Jf11./V'-- *
AUlhOiI!cd Sig"alure 1 ,- J. l-UMI'LETE 'FEE SCHEDULE BELOII
,1......., LOCATION OF INSTALLATION
I / () '2, '::21 I (j/) 4400 A. Ne... Residential-Single or
Multi-Family per d...elling unit.
Service Included:
LEGAL DESCRIPTION
L 1(,-0 J _oO.-tAvA ~ ~ 'WL..
, ,_ J9B DESCRIPTION ~
~ '""\ ''''''''''0 C~c.vJ\
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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_ CONTRACfOR INSTALLATION ONLY
Electrical Contl'actor (Y ~1..tJf
,
Address f.G, (l.~'f.-. 2J..'-{
City ~v:,0 Phone 7lil.f-0'70S-
Supervisor License Number -7,C,~'- 5
Expiration Date ]fl 11.4/0\
( -tf .
Constr Contr. Number L61-L..-Q'1C
Expiration Date loh_Y(qc;-
I
Signature of Supervising Electrician
~~
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O...ners Name :-(~ < Q. ,''5:. l., ,e r'L
Address "5 ~
City <:::.M IL Phone"ll('I-C(OI/
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O\INER INSTALLATION
The installation is being made on
property I o...n ...hich is not intended
~or sale. lease or rent.
Ovners Signature:
--------~----------------------------
DATE: '0 ---15-9"\
RECEIPT #: _0/ >r& '-17
RRr.RTVF.D RY: f...J~
Items
Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modu1ar'D...elling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
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
$ 50_00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Insta1la~ion. Alterati~n or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80:00
volts see "B" above
D.
Branch Circuits
.-
Ne.... Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ...ith Service
or Feeder Permit
$ 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 $ 36.00
5. SUBTOTAL OF ABOVE ,'~.S . OD
5% State Surcharge I ' 7 K
3% Administrative Fee I. n S
TOTAL $''57. c('O