HomeMy WebLinkAboutPermit Electrical 1997-12-3
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Zoning Lct.v
225 FIFTH STREET g"!Q/2 ---.~-01- . ELECl'RICAL PERMIT APPrAATION
SPRINGFIELD, OREGON 974).7hMI''>[j .'n M ,,-, J '2..ln
INSPECTION REQUEST: 726~376~ SIgnature City Job Numb7r . '-'\\O!t )
(I. OFFICE: 726-3759
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W.01 d~;\~ ilil .
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per.)ts are. non-transferable and expire
if ~rk is not started within 180 days
of issuance or if work is suspended for
180 days.
NSTALLATION .
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovner~~ignature:
-.
------------~--~- - -------
DATE:_ \.o-...U.~ \. ?\\v/}./
RECEIPT 11: \ h ~H.O ~
RECEIVED BY: T ~
3.
COMPLETE FEE SCHEDULE BELOV
, A.
New Residential-Single or
.Mul ti-Family per dwelling uni t./
Service Included:
1000.sq.ft. or less I
Each additional 500
sq. ft or portion I ()
thereof
Each Manuf'd Home. or
Modular. 'Dwelling'
Service or Feeder
D.
Branch Circuits
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
4 Installation, Alterations
Electrical Contractor~__.:_~,J~&1~ or Relocation:
Address 0.0. 'i}.....~ , I " " 290 amps or less
: 201 amps to 400 amps
Cityt.J~\+...~~,JIL ~~:7c('-'16'ff 40.L~mi>s to. 600 amps
c: tlI'R~9.LLEXPIRE IF THEtWl1Mlimps to 1000 amps
Supervisor License NitI.Ill.~t:", '. L; '5 _' d~ PERMITIlYfmr1000 amps/volts
~~~ri'..~lPn lm~. . /reconnect Only
Expiration Date /0- -:.' ,'..' ~QR'~.M1At!lOONEOFOR
r';;\~"", ,-c..' . . :,",,J;,~.) Temporary Services or Feeders . .
Constr Contr. Number~~9~~~IOD. Installation, Alteration or Relocation
Expiration Date ~ _~""l:.I'l~S;;; ~~~\0\.J. 200 amps"oT less $ 40.00
. .~".. ~.
201 amps to 400 amps $ 55.00
Signature of Supervising Electrician Over 401 to 600 amps $ 80.00
./J /J Over 600 amps or 1000 vol ts see "B" above
;V J II/A -t'";'=: A...
Owners Name.. N\;infiJ ~
Address ,l em l ()~ltw
Ci t Phone -ifl.;Q1ro..
Items Cost
Sum
$ 85.00 P{)
$ 15.00 q D
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
"
New, Alteration or Extension Per Panel
Miscellaneous (Serviceifeeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or. Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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