HomeMy WebLinkAboutPermit Electrical 1996-7-29
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SP4.FIELD
zoning, and does not require specific land use
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72 6- 3 R;tJ""
Authorized Signature
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225.FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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3.
1. )"Q~~TION OF INljTALLATION
"4-"tD mA.' III
ELECTRICAL PERMIT APPUCATION
City Job N~ber
q(p 07 ~L/
COKl'~TII nil SCHEDULE BELOII
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
1"'7 (] '2., 3~ 3/ 07 %()O
Items Cos t
1000 sq.ft. or less
f! : 1'/, ""6- r/.l1fJ C(cRe.,. 7-Each addi tional 500
~ sq. ft or portion
Permits are non-transferable 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
JOB DESCRIPTIOIi
,+NSfl9-/ll}t,'~~' elf.!
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
. 0 l' Installation, Alterations
Electrical contractor,kil tfl7f((C~"'~M 'J.1~r. (rvcor Relocation:
Address .3 rb 51). Jj nil, 51"" 200 amps or less
201 amps to 400 amps
CitY,S(JnnCJ-(;eld Phone 7L/7 ;(OS'ii' 401 amps to 600 amps
, . 601 amps to 1000 amps-
Supervisor License Number 3'7 35" S Over 1000 amps/volts
Reconnect Only
Expiration Date /0- j- 'iJ'--
$ 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
Cons tr Con tr, Number 770 <) <,-
Expiration Date
/~-I-C;c.(
Signature of Supervising Electrician
Name
~
g."h i5e/IfW'C '"
IYifhn :5/
Phone 7L-jl-~7&/
Address LJLJO
Ci ty \:-) QV
I
01lNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
-------------z=------------------------
DATE:_7-a~ - 9("
RECEIPT #: U -0-.'.)(.. 8- ( .
RECEIVED BY: I)' i Yk:~..)cr&1 ()
200 amps or less
201 amps to 400 amps
Over 401 to 600- amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$80.00
see liB" above
D.
Branch Circuits
New, Alteration or
Extension Per Panel
$ 35.00 35,r}?J
I
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
05, {JV
1./5
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