HomeMy WebLinkAboutPermit Electrical 1997-6-26
The fOllowing proJ&Ct .
zoning, and does not ~:qS~~om.itted..~~s tho folJo\VinQ
approval.' PGC/J/c Ic.:nd USa
Zoning 1-rJ... (L--
97477 D'<lei!_).f.t,-f.(:!.
726-3.169ri2ed Signatur.J All
225 FIFTH STREET
SPRINGFIELD. OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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')) JOB DESCRIPTION L
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Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days. .
City.Job Number
ELECTRICAL PERMIT APPLICATION
'7'>~?:.- ~
Ney Residential-Single or *
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Service Included:
3.
A.
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular.Dyelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
\ \I\\}_^_' . ~. .0 -\-Installation, Alterations
Electrical ContractorM1tll7-~e , ~ \\1f( Ueo or Relocation:
Addres.s \)() ~ \ \ \ . '.. 200 amps or less . I
City~~y\ \wnli\\p Phone l41o~. igi =:~~ ~~~gg ::~~
'). 'J..() Q 601 amps to 1000 amps
Supervisor License Number ,)..J'\ \D-J Over 1000 amps/vol ts
\r--. . \.' Q 7 Reconnec t Only
Expiration Date \ ) 7
Constr Contr. Number \O~
Expira t ion Da te
~.\~. 98
Sign~Ure of Supervising Electrician
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Oyners Name /f tv~ ~#U/~A'>5 D.
Address /H:./?,~ :y-'
Ci ty ~~~L> Phone "? f/&/.~a.
.. .
OIINER INSTALLATION
The installation is being made on
prdperty I own which is not intended
for sale, lease or rent.
C.
Cost
Sum
$ 85.00
.$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300;00
$ 40.00
s-~
Temporary Services or Feeders
Installation, 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 0'. 1000 volts see "B" above
Branch Circuits
Ney, Alteration or Extension Per Panel
One Circuit
. Each Additional
Circuit or yith Service
or Feeder Permit :1
$ 35.00
$ 2.00 ~
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limi ted .Energy /Comm $ 36.00
Oyners Signature:
~~~~~-Jf-:~~~:~:;-------------
RECEIVED BY:-L(f ,
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL.
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