HomeMy WebLinkAboutPermit Electrical 1995-4-27
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225 FIFTH STREET Dal. q -1.-7 --'1) - ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 1'\ /) ,
INSPECTION REQUEST: 726'.!!!3'l'llIJld Signalure /J "^- City Job Number '/.5"D, 5' 7 S
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
4 ~ C:::> 2. d 1/tC../?'Y.7
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCR,lPTION
)tj;,CJ2- D S JI
/y2..7-1772
JOB DESCRIPTION
7L~/7 , 4-,~
6IV
(
(Ju'i~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
. 2. CONTRACTOR INSTALLATION ONLY
,
Electrical Contractor ~fiVJU//
h_~ ,"-
;&'// A/ / C;/ ""'-
Address ~ 7~ 7Zf'wA'5'71J>rJ ~ '
Ci ty~' Phone 747 -ue; .J
Y I .....,. ~
Supervisor License Number C..2~1? L-
Expiration Date /2-;2CJ -7'~
Constr Contr. Number
Expiration Date
@ ,~",""''''ddd~
Owners Name
Address
City Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------~~---~------------------
DATE: d/27 / "j..r
RECEIPT II: .. IIr~'h
RECEIVED BY: ,t(I/'X':. ~ (
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular.Dwelling
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
Over 1000 amps/volts
Reconnect Only
It ems Cos t
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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 1000 volts
D.
Branch Circuits
~ $40.00 ~
$ 55.00 '
$ 80.00
see "au above
..
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
4e; ,d-tJ
, ?_ t!AO
/2.0
-r4?f~
T/r
40.00
40.00
20.00
36.00