HomeMy WebLinkAboutPermit Electrical 1995-1-17
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The following project as submitted has the foHowin
zoning, and does not require specific land use
approval. t CJ ELECTRICAL PERMIT APPLICATION
97477 Zonina t1e:!.'l'Y'\ k1
726-376~/""""6..( Ci ty Job Number ~\~ 11. )\'
Dota' , 1 I J
Authorized Signatura f" rf.- COMPl.ETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION
?~2.. 7 /... r-"-_~-I )r-
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225 FIFTO STREET
SPRINGFIELD, OREGON
INSPECTION REQuEST:
OFFICE: 726-3759
JOB DESCRIPTION
C~rv '0,-"-/"/
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 B.
Electrical contractor'?/" /_~....'" )....1'_ ~_I:J
Address J 2 /)~ h./(- .u?.A -
: ,
City E:o('''~ Phone
I
Supervisor License
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof :
Each Malluf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
-;;</5 -Snr-
Number 7-f O.?L
/o/9t
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
60l amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Expiration Date
,
Constr Contr. Number 9oj't:>b
Expiration Date
L//4~
The installation is being made on
property I ovn vhich is not intended
for sale. lease or rent.
.
Owners Signature:
--------------------T'f -----------
DATE: 1- ,.<.f) ,
RECEIl'T jj: _ L\ ._..! . II j,,\( 7..
RECEIVED BY: ~ l_J v~
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
S 60.00
$100.00
$130.00
$300.00
S 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
Signature of Supervising Electrician
/~ ----.~ r
o / , / D. Branch Circui ts
Owners Name ~y.. U /'/"4fr<<7'/4,J/'/t//C"f J
- ,,/ / p? New. Alteration
Address I?/ 6'/?,,,JxJOO,) cr
City ZS7,?<.-L/ Phone ?V7/vz I
OVNER INSTALLATION
volts
S 40.00,
$ 55.00' ,-
S 80.00
see "B" above
or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
S 35.00
s
2.00
not included)
/
$ 40.00
S 40.00
$ 20.00
S 36.00
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