HomeMy WebLinkAboutPermit Electrical 1996-10-20
- 'f ":0 following project c.s sU,bmitlad, ~as the following
toning, and does not reqUire Spe<:ltlC Imnd use
approval., L Dfl.--'
- Date ll)ljnJq{~' - '. - -,
9~}~i~~%~ SignatUre i _. rn~.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPEctION REQUEST:
OFFICE: 726-3759
,
ELECTRICAL PERMIT APPLICATIO~
Ci; Job Number ? b /3-1t)
3. _ COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLAT~ON
~~~ ceEs I L.-JJt
A.
LEG_ ALI\~_ ESCRIPTION
J!ys/!Aqu~
() JOB DESCRIPTION' -
DW ~ ~-l6D e.6Ha[)E; t-
Permits are non7transferable and expire
if Vlork is not started VIi thin 180- days
- 6f issuance or if Vlork is suspend~d for
180 days.
2. CONTRACTOR INSTALLATION ONLY
- '
_B.
Electrical Contractor~~~~ ~~
Address 3323& CR..1tl& locfJ
Phone9lfJ-1 D'i 0
'Supervisor License Number ~ 7~
Expiration Date /6k/rJ!
- I ~ / -
Constr Contr. Number. ~~~J1 7'
Expiration Date If;? ilf7
c~
C i t Y 61J..DJF_
C.
, ,
Signa~~erViSi
OVlners Nam: b(l{ (
Address! l.~
City ~O_
\
OVNER INSTALLATION
Electrician
~'bo 1 ()
DT Lj-J
D.
Phone
;
,
The installation is being made on
property I ow~ Vlhieh is not intended
for sale, lease or ren~.
E.
Owners Signature:
----rIP- ----r---------------~----------
DATE. ,,0 -60- G (.d -
RECEI T #: Od..l,<.e5h- - .
RECEIVED BY: --
, .
5.
New Residential-Single or
'Multi-Family per dwelling' unit. -
Service Included:
Items Cost
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
- sq. ft or portion
thereof $ 15.00 -
Each Manuf'd Home. or
Modular -Dwelling
Service or Feeder - $ 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_
S 50.00.
$ 60.00
- $100. 00
$130.00
$300.00
$ 40.00
Temporary Services or Feeoers
Installation, Alteration or Relocation
200 amps' 'aT 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
\
Branch Circuits
,
New, Alteration or
Extension Per Panel
$ 35.00' g5/"
I
One Circuit
, Each Addi tional
Circuit or with ServicJ--
or Feeder Permit ~
2.00
/0
$
Miscellaneous (Service/feeder
-Ea~h installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
_ TOTAL
$
$
$
$ 36.00
J/~t/c)
40.00
40.00
20.00