HomeMy WebLinkAboutPermit Electrical 1995-2-16
,
..
~
.-
. .
a olJowlng proiact 'b'
zoning, and does' not as <>lJ, mitted h,"-s tt:~ f
approval. reqUIre ~peclflc loud lJ~
225 FIFTH STREET Zoning CD f2-- ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 -r ' ;jJ I I 2eA
INSPECTION REQUEST: 726-376lf'2---111~7) City Job Number Vt 'i 0->> /
OFFICE: 726-3759 AuthorizadSignatu AIM
ra !h ~OMlf'.F.'J.:E FEE SCHEDULE BELO\I
1. LOCA;q:ON W JNS~LATION ~
_ 1L-1~ ~~:.i, ORJ/\pY>' A. New Residential-Single or
Multi-Family per dwelling unit.
~~D IO~ 'Service Included:
I f U"J , f, u'?f75D ' Items Cost
JOB DESCRIPTION
cyArlf17 R -+- 7_ G( V'(L'-\;~
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
Address
City
Phone
Supervisor License Number
Expiration Date
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
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00 CViJD
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name-/-0v-r~V\ ~(JVVlY5n_
- u
Address ~ Z 1ifJ ,~J. / ,{t\ f;-r Ed
Ci ty C;;; ,(2d Phone f ~tf-- 2fJ2b
v
O\INER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
------------r,---~---------------------
DATE:_ 7--r0 -7?
RECEIPT #: 7!t??d-j
RECEIVED BY: IY'~
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
.'
One Circuit $ 35.00
Each Additional
Circuit or with Service , r~\
or Feeder Permi t ''7_____ $ . 2.00 I.><F.LU
not 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
$
$
$
$
tOy.W
j .('1. z...
? .re)
179:. '3 z...
40.00
40.00
20.00
36.00
~
Jo No,9L/tJ -;., ~3
f-I.It'I, & _
JOB
/;)7'!?
_II)
A-/J/)I7~JJA:1
CALL FOR REINSPECTION
.
CITY OF SPRINGFIELD
Development Services
225 North 5th Street
.
Building Safety
Date, rJ.-Ib-2.c:..
~
TO:
SL).~
(se?6J Ie;e- +- ,;1, ~ J
, ~
bu.E: -t- S' %
_ INSPECTOR
....CALL FOR: - INSPECTION 726-376\1 - INFORMATION: 726.3759....