HomeMy WebLinkAboutPermit Electrical 1997-4-17
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Tho following pmject as submITted h:~' t:~ 'fo:!o'::ing
zoning, iifJd does not require Si,ecl:IC 1...,";c;lli....J
apPrG./~1.
LOningM L
De!.a~-2"<r1
9 ~~%t~~f~ Signature
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1t;f~N ~l INhTh~TR~
-/ "'GD:f~~o}, D '-' 0 I
ELECTRICAL PERMIT APPLICATION
.:-' Lj Job Nwnber q7 D5 & t-f
3. COMPLETE FEE SCHEDULE BELOII
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
JOB DESCRIPTION
)11f'Y~ N~ ~~ ~~A"~
Permi ts are non-transferable' and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ---:J1+'LIf'~ bez.'f/i:..c..
Address ,=3/7D m~~ow L-N
Ci ty (;:ijJ-?l~~ Phone _Infl'€; -I,. I ;L(
Supervisor License Number 2 '1lc; S
Expiration Date
/o/9~ qi)
'2or79c
/ohy
Constr Contr. Number
Expiration Date
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
---------------------------------------
DATE: lj-/? --?'?
RECEIPT 11: :1"7 ~::t:?
RECEIVED BY: or .~_
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dvelling
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 1
Over 1000 amps/volts
Reconnect Only
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
Lj.
).00.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
1..::1Q20
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 100U
volts
$ 40.00
$ 55.00
$ 80.00
see liB"
above
Signature of Supervising Electrician
C-/-
NlfTH;;:; J;,~,p:::. 1\ L D. Branch Circuits
Owners Name--.lY1lln I c.fJ,L IOaCn
121 '2 (J b ~ ""-;d Nev Al tera tion or Extension Per Panel
Address--=.L _):10 D i{t"'~usr{,mt. '
Cityr()hurfr Phone qCft;,I{)0~ ~~~~:;H~go~~~h Servo $ 35.00
OIINER INSTALLATION or Feeder Permi t ~'b.CIJ$ 2.00 I (J). [i)
.'
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
40.00
40.00
20.00
36.00
$
$
$
$
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