HomeMy WebLinkAboutPermit Electrical 1996-7-29
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The following project as submitted has the follow!
zoning, and does not require specific land use
approval.
Zoninp t-J::;5f ./
97479Hte~.q~
726A0f.l<ij"l)ed Signature
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF
0717 .E
INSTALLATION
-
C'...p)k"r? j
LEGAL DESCRIPTION
1702. ':? 5 2-.3 /) 7~
JOB DESCRIPTION
/."/;/.4 ~ ~. ...<;' Pk' .
, ""-, , 1-
Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
SPRINGFIELD
,
ELECTRICAL PERMIT APPLICATION
W1
9607?,9
.. . -- .,
(';1:Y Job Number
3. COMPLETE FEE SCHEDULE BELOV
A. Ne~ Residential-Single or
Multi-Family per d~elling 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 D~elling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
.B. 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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date 200 amps"oT less _1...--. $ 40.00 4-0~
201 amps to 400 amps $ 55.00
Signature of-Supervising Electrician Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
O~ners Name ~ \ R1J6~
Ad d res s c:;- t::., ("'") c::;- t5" 7!:L s T ,.
Ci ty ~~ Phone ~h -Ic#)
OVNER INSTALLATION
The installation is being made on
property I o~n ~hich is not intended
for sale, lease or rent.
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DATE:
RECEIPT #:
RECEIVED BY:
D. Branch Circuits
,
Ne~, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ~ith 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)
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$ 36.00
4000
. 2-~
.12-U
.. 4-'2...2...0
I ~,
40.00
40.00
20.00