HomeMy WebLinkAboutPermit Electrical 1995-8-25 (2)
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S.FIELD
The, following project as submitted has the following
zoning, and does not require specific hind use
approval.
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225 FIFTH STREET Dcrte ~t, Zl5 j15 ' ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 974/) Y '^i.t "'-'j t'1 5
INSPECTION REQUEST: Ai..J;!':0iz.~~9nature ,11Vv - r.i ty Job Number -I I 3 q 3
OFFICE: 726-3759
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
~ J _ Installation, Alterations
Electrical Con tractor~L._1..f-_ ff<J ((~..-tltJL. or Reloca tion:
Address Q{) I g.>-1- \ ( ( , 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
'1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
City (D~t+~~llle
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Phone
Supervisor License Number
'=3 :57 (. 5
Expiration Date
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10-(_-"',)
Cons t r Con t r. Numbe r 2.0 - z. ~7 c
Expiration Date
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Signat~, of Supervising E~~ctrician
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Owners Name~~ r ~ Si~
Address rJLf&:A p{) A- H
Ci t Phone ~S,9 -/~7
O~INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: k.-' 2S- ~
RECEIPT #: (jJX/f2.S
RECEIVED BY: i\J~
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
$ 85.00
S 15.00
S 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
D.
Branch Circuits
,.
New, Alteration or Extension Per Panel
One Circuit ~ S 35.00 ..37".~
Each Additional
Circuit or with Service
or Feeder Permi t ? $ 2.00 ~fJ1P
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E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res S 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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