HomeMy WebLinkAboutPermit Electrical 1998-1-5
.
The, following project BS $ubmrttcd hns t;.. fo!~c':.liilD
zonmg, and doo~ not requiro Bpcc:Hc l:.r...:i L:':~
epproval,
Zonina
225 FIFTH STREET
SPRINGFIELD, OREGON 97477 Data
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759 Authorized Signature
,
1. LOCATION OF INSTALLATION
9~ .{~., -;-/~~)7_~, ~ ~Y"
LEGAL DESCRIPTION
~-/,~
I( ~ .,-
JOB DESCRI~ION
1t1'i?V~~A ;f;:",7- ~"",c'
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 ,B.
Electrical contractor!;{-'I"'('IJ"" F ,\R:+\"IC
Address ~\lS (u. do - F\ \Jc., :
City r l)n.~l'G Phone ~'-(~-)')..<11 .
i .
Supervisor License Numb~r ~ 5
Expiration Date IC)~) - ~<:;( ,
Constr Contr. Number (Jer.sd-.
Expiration Date
;).-9; -q r..
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovner~~ignature:
-,
DATE: /-'7 ~-:7s:.
RECEIPT I: 29:~SZ4!::
lUU"P'TU1:;'.n R.Y~ ~ ~-- ~
ELECTRICAL PERMIT APPLICATION
Ci ty Job Numb:r .9~- - ~
3. COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular'Ovelling'
Service or Feeder
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
Items Cost
Sum
$ 85.00
$ 15.00
$ 4'0.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Miscellaneous (Serviceifeeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
200 amps' '0. less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
E.
5.
SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL
Signature of Supervis' g Electrician
~...-?~
# ....- r " . D. Branch Circui ts ; .'
o Name~~ .
. '" ~New, Alteration or Extension Per Panel
Address.c;~ /~~A'"'.A?A'""C.
, - - .' One Circuit / $ 35.00 ~
City ~~ ~Phone ?V?.;<'~./&' Each Additional
,.- "T Circuit or with Service
OVNER INSTALLATION or' Feeder Permit ~ $ 2.00
voJ.ts
$ 40.00
$ 55.00
$ 80.00
see "B" above
~-e:>
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.'00
'"3~. -
/'~2
1,/-:>
q,<;2./"2..