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HomeMy WebLinkAboutPermit Electrical 1995-3-8 ttl 225 FIITH STREET Tn . , ELEcrnICAL P'ERHIT APPLICATION SPRINGFIELD, OREGON 97477 zor~i:'~I".:~;~~prOjscta9submittedhaoth f' qsn / I INSPECTION REQUEST: 726-37691rov:.t oeG not reqllire specifi~.I.iCh~o':J'(fu Number L ~L..{ '-j OFFICE: 726-3759 ' ~ I Zoo:ng-S,Ll-".. COHPLETE FEE SCnEDULE BELOI/ 1. LOCATION OF INSTALLATIokto~-~::5 )" . ,.c;C)(') '~~",.i,#~iJ.;?~!;.,,< ""_..--:-: /Il'L New Residential-Single or . .. -,-,o-~~Ml.ll ti-Family per dwelling uni t. LEGAL DESCRIPTION 03/0 { Service InCluded: 1'10-::' l ~ (YJ I Items '. ", ,..... Sum Cost $ 85,00 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder ~ JOB DESCRIPTION /hvt tJ fh ~ :vr $ 15.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days, $ 40.00 Services or Feeders Installation, Alterations or Relocation: 2, CONTRACTOR INSTALLATION ONLY Elect~ical Contractor Jf?~).1d~ ~;.'~Ct: Address .271'/.. (p""kf X~//. 3~?-72' ? 2d-1 ~!>(.... /tJ-- 9 S- Constr Contr, Number ~;7P?~~ /cJ~75 B, $ 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 ampslvolts Reconnect Only City~_..../ Phone Supervisor License Number Expiration Date Temporary Services or Feeders Installation, Alteration or Relocation C, #!!-- 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" Expiration Date of Supervising Electrician '4.c~_ /4 . , ;' - D. ers . Name S'hl)~ tLld"dcl .4d/'~4'/j,:1 Address C/r) 5(J() -r~ 1JftTi {)I..J!fL lV. Ci ty-- --60 PI L Phone above Branch Circuits New, Alteration or Extension Per Panel $35.00 One Ci,rcu it Each Additional Circuit or with Service or Feeder Permit S 2.00 OI/NER INSTALLATION E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation S 40.00 Sign/Outline Lighting S 40.00 Limited Energy/Res S 20.00 Limited Energy/Comm S 36.00 The installation is being made on property I own which is .not intended for sale, lease or rent, Owners Signature: //".A:"" ~~- .LP'7 Bf= ~ :;.7 , ~~~,~r;/cr:~~;-~-------------- RECEIVED Jl:L;......,,/ ..()1..J ~.t. A .~" 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL