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HomeMy WebLinkAboutPermit Electrical 1996-10-10 . Cd" lOr /o~ 7ft 9i'4'ti'riZed Signature 'jJ M 726-3769 ELECTRICAL PERMIT APPLICATION City Job Number q & /37 OJ .. 225 FIITH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 COMPLETE FEE SCHEDULE BELOY 3. LOCATION OF INS ALLATION . .,tio bq.o.-/. 2, , LEGAL DESCRIPTION' jJl'\).~ "I 703~5<-12(){"qcnl Ne~ Residential-Single' or Multi-Family per d~elling Service Included:' A. uni t. Sum Cost Items $ 85.00 '1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular 'D~elling Service or Feeder . JO~ DESCRIrrION- -\fl\titp~Q~L\'I\..I\"t~~ Tr.1 (l0c6h,J ~ ~n~n-transferable and expire' if ~ork is not started within 180 days o'f issuance or if work is suspe-ndedfor 180 days. I' $ 15.00 I ! $40.00 .Services .or Feeders Installation, Alterations or Relocation: 2. CONTRACTOR INSTALLATION ONLY ,B. Ele.ctrical cont~actor(f~~f:DO(\t,{lf\ 'i~' Address~. ILl-Z1-.J , Cit~C)W~ Phone '1t+I-j1.~b.. . ()\} Supervisor LIcense Number ~hS Expiration Date 10 -I-q 2 Constr Contr. Number ()'324Q Expiration Date q"-I -qrJ S 50.00 5"0,00 $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 , Temporary Services or Feeders Installation, Alteration or Relocation C. 200 amps'. 'or less $ 40.00 201 amps to 400 amps '$ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 100v volts see "B'" a~ Signature of Supervising Electrician aA....~q ~~. D Owner~ Name.IC.l.Q.n h~O\.;(.' ~ tOniL. . Address~i\-.' 7J . Ci ty p~ l ~o \ . Pho'ne!liA :-:3"D 0 lo OVNER INSTALLATION Branch Circuits' .' New, 'Alteration or Extension Per Panel $ 35.00 One Circuit Each Additional Circuit or ~ith Service . or Feeder'Permi t $ 2.00 E. Miscellaneous (Service/feeder not included), -Each initallation . Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 . Limi ted Energy/Res . $ 20.00 Limited Energy/Comm S 36.00 The'installat'ion is being made'on property I o~n which is not'intended for sale, leas~ or rent. Ovners Signature: 50.00 1. =io ,j._'i"n .&j: On 5. SUBTOTAL OF ABOVE 5% State Surcharge .3% Administrative Fee TOTAL ------------------Zf~----------~---~-- DATE: IfJ -/0 _vlp " , . RECEIPT 1I: 2~tI<;?, RECEIVED BY: tV;