HomeMy WebLinkAboutPermit Electrical 1994-10-6
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SPRIHaLO
225 FIFTH STREET The, fOllowing project as sUbmlllecf'-- tRJ .R~CAL PERMIT APPLICATION
zoning, and does ' IM:S mM'CI
SPRINGFIELD, OREGON 97477 appro'val. not reqUIre c~odfic lood u.e
INSPECTION REQUEST: 726-3769 " I 1"\(2 City Job Number q ,,/ / .il :/ ~
OFFICE: 726-'-3759 Zoni~~ 'lA/ ~ . /
Dme 10- c,.q'-( 3.
1. LOCATION OF INSTALLA~N~.
"21"f1 &' A'"~....(} ~rizedSignature~ New Residential-Single. or .
- , i },4.3/ /MU.1U-1"-<1",.1>.:r per dwellIng "Unlt.
LEGAL DESCRIPTION ~/ . Service Included:
Jil;!L/J - J -;(/)2~~ o"":>D9b? Items Cost
JOB DESCRIPTION 1000 sq.ft. or less \ $ 85.00
A/t:1.u/ < ~R Each additional 500
" sq. ft or portion 1\
Permits are non-transferable and ex~!te thereof ~
,if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor \\\\Uu \}uI'h>;r.
~ v.1 c...-k> H:f-
Phone I--nS-Jl:'l9
Address \:4.. '::-:,\ "- ")
Ci ty N\r-.!wA <...
Supervisor License Number I n{J(oS
Expi ra t ion Da te I (')-I-Ci ;-
Constr Contr. Number Gc~\4~
Expiration Date q-i./ -q:;
Si~~e of Supervising Electrician
~~--~./~
Owners Name U g ..L.
Address 1>99
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'7 <ld-&,1'd6
5. -";::1
City -:S'~D.
Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature: .~
)J;fip.;:? d /ft/Y~/...:;;>
DATE~--~--~-~--~-Il:J~t2i ~--------
RECEIPT JI: J _ (\VI i ";--,,
REC,EIVED B~ lJ. Y(L./'~
COMPLETE FEE SCHEDULE BELOV
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
,
Sum
$ 15.00
ysc;
30
$ 40.00
$ 50.00
S 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
$ 40.00
S 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Add it ional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
$
$
$
$ 36.00
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40.00
40.00
20.00