HomeMy WebLinkAboutPermit Electrical 1995-7-14
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The following project es su m
zoning, end does not require specific land usa
approval.
225 FIFTH STREET Zon;no !.--f)t:-
SPRINGFIELD, OREGON 97477 -
INSPECTION REQUEST: 726-g,,",0
OFFICE: 726-3759
ELECTRICAL PERKIT APPLICATION
City Job Number
QS\D\f;
Authorized Signature
rJ(V1
.1. I;U1U'LJ>L'" ru. SCHEDULE BELOV
1.~~ ~~I~t~
\\~SmION CC5\~
~OB DES ("\ ""Nf) 1000 sq.ft. or less
It j l:'a~ ~ IU\ Each addi tional 500
: - . sq. ft or portion
Permits a e non-transferabl and expire thereof
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular, 'Dwelling
180 days. Service or Feeder
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor i.9VAI~5 ~~
Address 2/0 W~UI<; "# C.
Ci ty Eu.;ar.;ri! Phone t::.S7 -13(;,2
Supervisor License Number ;3~~1 5
Expiration Date 1t';I/;l1J>
"
Constr Contr. Number. 7~ 7&;.2-
Expiration Date ' ~;lGP~'~
Signa~u~ of ~ervis~ Electrician
~,t:(~ ~
Owners Nam~. 611lJ\~
Address \--rtQ \\f\~ nO..O ')
Ci ty ~ \J}one ~\-36~
, \5 .
OVNER INSTALLATION
The installation is being made on
property I o~n which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT j1:
"V,..r.TUPO ll.V.
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
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
Items Cost
o
Sum
,
$ 85.00 !O;i
$ 15.00 100
4
$ 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 or less ~
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00 1-0<(}<)
$ 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
$ 35.00
$ 2.00
no t included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
/~5.~
"f.-.S
.0;. S-.r
lqq> ..,0
40.00
40.00
20.00
36.00