HomeMy WebLinkAboutPermit Electrical 1995-9-11
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The following project a .
zoning, and does not r: s~~rr~ittOd't~as tho following
225 FIFTH STREET approval.. q pecIoIC land vSELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonina W q 5\4@
~~~~~IO~2~~~~T: 72~~~!J-1I1 '\,- City Job Number "
1. LOCATION OF INST~~~;ed SignHtura tJ~. COMPLETE FEE SCHEDULE BELOIl
'?Si{f) r~IA;I{/w)'1/ A. New Resloential-Single or
1 Multi-Family per dwelling unit.
1-Hi4!-tJ W:~~ION 0 Service Included:
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JOB DESCRIPTION
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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
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:
Electrical ContractorJ1</~~ Ifrn{p
(I.
Phone 5'42 - n~q
Lt 55 5
3/tt7
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wi tit 7
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Electrician
Address ;01../
Ci ty {;IA/~ '
.T (J My-I 0"'"
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
Supervisor License Number
Expiration Date
Cost
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
Constr Contr. Number
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Signature of Supervising
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Owners Name hoQS-\-ge..-.
Address 00 ~ i.41~
City~ Pho:e
OWNER INSTALLATION
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
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New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting~
Limited Energy/Res
Limited Energy/Comm
Owners Signature:
------------n--l--~-------------------
DATE: Cl,1\ tic:; . 1/
RECEIPT #: g;!'1<(,fIP /
RECEIVED BY: l~N
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ .2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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