HomeMy WebLinkAboutPermit Electrical 1998-5-18
,
.
The following project as submitted htllllho to!
zonl"-.l and does not require spociflc land uno
a: "'.....~al.
Zoning l6. V
c 5--16-4g:
9747,Z"iOfized Signature 1\'\ '("\("'I
726-3769 -
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REOUEST:
OFFICE: ,726-3759
1. LOCATION OF INSTAL~ION
I~I C) '. (:>.V""\~N_rA ...,,,
II) t-5.~~~I~ '
ELECTRICAL PERKIT tf,PLICATION
Ci-t?'- Job Number V\~[,)M~
3. COMPLETE FEE SCHEDULE BELOY
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
Sum
~:~':~~~"b:' "., "pi,. :;l:,!!:!;i::;::!!~
if vork is not started vi thin 180 days Each Manuf'd Home. or
of i~sua~ce or if vork is suspended for ~dular 'Dvelling
180 days., u..~ ~OS'e~vice or Feeder
\~~t' c.,~O
2. CONTRACTOR INSTALLATION ONLY ~i-\l~\'?-~ ~~~swvices or Feeders
~.... ',\;,,, ~\W ~\~ ~.o...."\(l ~~'Stal1ation, Alterations
Electrical Contract'l.F'~\V"'..\'(':l'f-l"'" ~ ~O~€ or Relocation:
~- ~'" '\j~\j 'S>~~...... '
Address ~. U I \'1::>'1 ~ ~O f'o.\~~ , 200 amps or less
~- \)7 _6CV'; 201 amps to 400 amps
City y,,'^-l.... ~,.l..c ~o ~f9IWI'.Qj 401 amps to 600 amps
~~~~'~~ 601 amps to 1000 amps
Supervisor License Numb'P~ -1,\\, L\ IS- Over 1000 amps/volts
I Reconnect Only
Expiration Date \1:> \ , P)"I
Constr Contro Number \'dSt.:" ~
Expiration Date \11/1:'/ ~1
I
Signature of Supervising Electrician
~ V v1A )
Ovner~ Name. C. ~n:.~~~,.f \~~ ~D.;..
Address <6~ ~~ Nc.A b-v<-'
Ci ty <1.A^\ ('vC/ Phone II...,l..\,;;: -1~(,,'1
OVNER, INSTALLATION
$ 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' 'OT 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
Branch Circuits
.'
Nev, Alteration or Extension Per' Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
. Pump or irrigation $ 40.00
SignlOutline Lighting $ 40.00
Limited Energy/Res 1_ $ 20.00 ~LL-
Limited Energy/Comm $ 36.00
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
DATE~----------l----~----~~"~------
RECEIPT 1I: J ~5 .!). -ro, '
RECEIVED BY: ~~ . V'\- .3\ 1)
, '- \ \
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
Q'~F
\ ~v
h"
'J\ c...\l