HomeMy WebLinkAboutPermit Electrical 1996-2-26
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225 FIFTH STREET Zoning rV\ 1'\ 0 ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 -r.,\ ~ 0/
INSPECTION REQUEST: 726-37j;9IG~~ City Job Number-LLocx:::t'>1
OFFICE: 726-3759 Authorized Signature
J. :ellP~E FE&--SCHEDULE BELOII
1.
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JOB DESCRIPTION \ .(1
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Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if,vork is suspenaed for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
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Elec tri cal Con trac tor6uc;,;:NE, h",c:;c:r1lJcS,uc.,..!NC
(PI+1"L,Ui." .)
Address I?n UnA)""/; ~T
Ci ty r-JA(;~(7 Phone O<../I./.;2";':;/DI
'M402.
Supervisor License Number loq 7,5
Expiration Date
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A.
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
Items
uni t.
Cost Sum
$ 85.00
,
$ 15.00
$ 40.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
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
Constr Contr. Number qnZO{)
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
.2. . ,1..:1..:..9.//0
Signature of Supervising Electrician
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Ovner's Na~ ~ ~
Address ;:!IJ. ~ -'/,f/t11
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Ci ty~ -1'~ne 7.:1 L4~ IP;2.
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O\INER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
D~TE~-~-~-~-~<1:~------------~-
RECEIPTli: ud-O :::y u , __
RECEIVED BY: D. yy\. J"'(.hO-Ou..
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
Nev, Alteration or Extension
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E. 'Miscellaneous (Service/feeder
-Each installation
Pump or irrigation '.
Sign/Outline Lighting
Limi ted Energy/Res'.
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administra,tive Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see liB" above
Per Panel
$ 35.00 ~~~~
'Z~
$ 2.00
not included)
$
$
$
$
31,~
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1.:...12 -
40.00
40.00
20.00
36.00
./