HomeMy WebLinkAboutPermit Electrical 1997-9-15
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The following project as submitted h.Gs the followin;)
zoning, and docs not requlro opadfic land UCQ
approval, . -;")12- ELECTRICAL PERMIT APPLI~A O~ .
97477 Zoni"" Lv (\ I n
726D~~~ I ! S l'lr - . Ci tyJob Number V\ \ 0 t
Authorized Signature 1. IrJ ~TE FEE SCHEDULE BELOII
1. f\f;t\r-~t \~~t~TION - A:
\ ~~'i:J:lfn1'l&[)O
~~:r:~:~f~~:" ~"d .,,;,
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Ci ty
STALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~E~-------7--~--~7CQ~~'i'--~----
RECEIPT b: rA. 1\ f\' ~ ~
RECEIVED BY: . I !)A ,j( I I ./ - .
. . V vJ~'--
New Residential-Single or
Multi-Family per dwelling
Service Included:
Miscellaneous.(Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
. One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administratjve Fee
TOTAL'
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
\ II\Y , '(), ,C\ -:tInstallation, Alterations
Electrical ContractortoJ.' pf\?-~e, 'l\\\1f'(UeOor Relocation:
Addres's \)() ~ \\ \ N(\... . . _' 200'amps or less $ 50,00
Ci ty~ \W\\Ji \\p" pl~~!\D4-<6. ~gi ::~~ ~~ ~gg ::~~ _ ~l~g:gg
~urH.~' ~ 601 amps to 1000 amps $130.00
Supervisor. License N~rO~ ~~G Over 1000 amps/volts $300.00
" AA;;-".~ Ut\10 ., :orPI'" Reconnec t Only' $ 40.00
Explratlon Date '~#~~\' ,~R~l.. 'i~/~
\ ^ IS ""77TS P .C. ~8'ijW.?:ary Services or Feeders
Constr Contr. Number~ c ,'. ~8-4AJ~ ~""41lr~rf~lation, Alteration or Relocation
(\ U ~ Ol\lcD S 1\10 (.d.J\
Expiration Date ~.\~.q 1\ ~Ot$O(J7;.mps"oT less $ 40,00 .lLL
.201 amps to 400 amps $ 55.00
Sign.'~~fre of Supervising Electrician Over 401 to 600 amps $ 80,00
1(/ /1 /I, .t.' Over 600 amps or'lOOO vol ts see "B" above
a........r (IA..;J!;,-<-<- ,
l I . .1\ ~ n D. Branch Circui ts
Owners Name \'J..lt\MUI . \~ Y-
'1\ h^ ....,~ l~ New. Alteration or Extension Per Panel
Address~ 0 ~) \\)'" C)\
. Phone ~ -"1: 01Q)
uni t.
Items
Cost
Sum
$ 85.00
'$ 15.00
$ 40.00
$ 35.00
$
2.00
not included)
$ 40.00 .
$ 40.00
$ 20.00
$ 36.00
41?f2
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