HomeMy WebLinkAboutPermit Electrical 1995-5-11
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The following project 2.S submitted has the follow
zoning, and does not require specific lnnd use
epproval.
Zoning LD f2--.
974rPtrtJ)-'f1 ~5
726~.edSlg""ture )J,..."
ELECTRICAL PERMIT APPLICATION
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
9SLJS//2
l!itv Job Number
3. COMPLETE FEE SCHEDULE BELOY
1. WCATION OF INSTALL4JION
~5"?L ~//~r~iG A.
LEGAL ~ESCRIPTION c;;.; c.v--&o\ 11:::.\-0-.
j? ~~-':2..,.,~~ ~7/t6
L~;~~~ 5p~~.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
It ems Cos t
1000 sq.ft. or less ~$ 85.00
Each additional 500
sq. ft or portion
thereof .~ $ 15.00
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder $ 40.00
Sum
.&5
75
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 contractory).tt f-U~
Address -. :5<f' a. CU",Jki-r..
City c;70~ Phone 6W-:J5'f9'
Supervisor License Number c: 7~-S
Expiration Date /() -/- 7'.5
Constr Contr'. 'Number ~ --lr-0
B. Services or Feeders
Installation, Alterations
or Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00 o/'~.-Z:>
$ 55.00
$ 80.00
see liB" above
/D -(-1..5
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 Electrician
JL,LJ ~
Owners Name-MIfF ~~A/
Address 25S?? /Y'~/? ZC2
City -<;~~.Phone ?~~.;;>3
- " ";;':?t??
OYNER INSTALLATION
Branch Circuits
D.
"
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
'$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
;::<,,~.--
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5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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DATE:__ 5-11-9'\ .
RECElt'l' 11:. (()/7~7IO /. '
RECEIVED BY: ~ J..... ~.J'~
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