HomeMy WebLinkAboutPermit Electrical 1995-12-6
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SPRINGFIELD
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zoning. end does not require $pectflc lend use
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Dato 1'2. -It; -'15
97477 AuthcrizJd SI9n<>ture ~..0
726-3769 J \
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number q ,C:; I f; & q
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Cont"actor~S Pful(l'ttUlI)~.
7 1
Address_P.O, @-.~, l~g1-.,
I
City~ Phone
Supervisor LIcense Number
1. LOCATION OF INST}LLATION
~~ In ~ IYI C\4J.nt IU o.l \
LEGAL DESCRIPTION
t70/- 30 Lf-s
01503
JOB DESCRIPTION
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Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
,.,41-1,1,3fo
1102hS
Expiration Date iO - I -<th
Constr Contr. Number Otl2q.Q
Expiration Date (j-I-ql:,
~2~v~cian
~:ners Name~.l~ (/,.. OJ l~ J
Address~t]~~ &~, I ClTID Q I
Ci t~M~Lphone rf 44 -1/2>15
OYNER INS~~LATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DA~E~~---~<=:--t1r~------------
RECEIPT #: (<) \ 9/ ~ "2-
....n..,...Ttmn nv. ...... f'\A f6tI w,A,l.J .I""" .
3. COMPLETE FEE SCHEDULE BELOY
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I terns Cos t
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dvelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
50,00
C,
Temporary Services or Feeders
Installa~ion, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80~00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circuits
.'
Nev, Alteration or Extension Per Panel
One Circuit
Each Add it i onal
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2,00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not'included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
5r), 00
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