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HomeMy WebLinkAboutPermit Electrical 1994-8-18 . . SPRINGFIELD Tho ""0wlo9 -'eel z" '0 d"" YJ Q.D ~ubmm-,..f IHiS tne 'nll", ' ,. . oee not require so< . ,.,:. '. "!l_ e, I' .. ,. "'ELECTRICAL PERMIT APPLICATION 225 FIFTH STREET SPRINGFIELD, OREGON 97477 '"~ C-v INSPECTION REQUEST: 726-3769 <?r lit /f. OFFICE: 726-3759 Q~..,r 1, LOCATION OF INSTALLATION-~ ~igneture 0 ~ 3/7'2 c:;~ /..;:l ~ A. LEGAL DESCRIPTION / /7 /J? z. Z 2... t') q?'o~76 City Job Number COMPLETE FEE SCHEDULE BELOV New Residential-Single or Multi-Family per dwelling Service Included: uni t, Cost Sum /'O? ej'/J"1) Items $ 85,00 1000 sq.ft, or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder . JOB DESCRIPTION ~ j/~7.lkA 6J, f#.PY $ 15,00 Permits are non-transferable and expire if work is not started ~ithin 180 days of issuance or if,work is suspenaed for 180 days. 2. CONTRACTOR INSTALLATION ONLY $ 40,00 Services or Feeders Installation, Alterations or Relocation: B, Electrical Contractor /.J..).v<{_N p;-....~~z.... $ 50,00 $ 60,00 $100,00 $130.00 $300.00 $ "0,00 ,( t1 ill S' P .,.p C!. Co Phone 1(P"Y"fJ~ /..( tfR Supervisor License Number /2. R~I / /;/f?92 Constr Contr. Number J..(") -'5,7((, rff /0/ / fq" { Signature of Supervising Electrician y J2t..- aJ-'<-'A-2- '. " Owners Name~!,5 ~~W 200 amps or less 201 amps to "00 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only Address (C;l.{Q\Q...U.1l2- Q City Expiration Date Temporary Services or Feeders Installation, Alteration or Relocation C, $ "0,00 $ 55,00 $ 80,00 see "B" above 200 amps or less 201 amps to 400 amps ----- Over "01 to 600 amps Over 600 amps or 1000 volts Expiration Date Branch Circuits D. New, Alteration or Extension Per Panel Address $ 35,00 One Circuit Each Additional Circuit or with Service or Feeder Permit City Phone $ 2,00 OVNER INSTALLATION E, Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ "0.00 Sign/Outline Lighting $ 40,00 Limited Energy/Res $ 20,00 Limited Energy/Comm y $ 36.00 ~- 5. SUBTOTAL OF ABOVE ~,_c- 5% State Surcharge I: f;?e> 3% Administrative Fee L. D 2l!., TOTAL -:?~ ~ The installation is being made on property I own which is ,not intended for sale, lease or rent. Owners Signature: --------------------------------------- ~ -c'B -;, 'Y 1L/3..r~. ~;'--l~----' DATE: RECEr'PT #: RECEIVED BY: