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HomeMy WebLinkAboutPermit Electrical 1997-12-29 b it'.,.d'-.......' ..'CIIC\,'.flJ The 1ollowing prolect as r.u. m .: ~. I.' ...~ . end does not rcqUlr~ t.)....."'.... . zoning. Eopproval. 225 FIFTH STREET zoning:Lch ( ELECTRICAL PERMIT APPUCATION ~~~:~~~~REg~~~~ 9;~~~37.6~ ~ 'df151 Ci ty Job Numb~r '. a. ~ I ~ \ ~ ~ 1+ OFFICE: 726-3759 , 'h -ized Signature' Y\ "'^ ,.u. o. -'-3. - COMPLETE FEE SCHEDULE BELOV 1. LO~TI9P Pf ~?TALLATION 1\ ~O ~~) _ tJ\ U'-ill"1-::1 0 \. ,~'" A. Nev Residential-Single or - -?v. A l...~ Multi-Family per dvelling unit. ~AL DESCRIJ;J;ION O~~Q ~;;;k' . Service Included: \'I()?l~~~"':l ~/' v,,. Items Cos ''J- '/<-11 '<'b .s:''S:1, ~D~CRI~iJ:Ort... n&AZf2~'O Cttlta '(<sOO sq.ft. or less \ \01 0]\\(10.1 \Ct..- ..,.::rv..a.t Ot$> ~t$> additional 500 . -' -' ^'<.<; {s> '%-&: ~~t or portion 5 Permi t are non-transferable and expi~Q -?O>~ ~~ if vork is not started vithin 180 days ~ ~~ a~~d Home or of issuance or if vork is suspended for ~u ~A~ling 180 days. Se 1B-9~e~ Feeder 2. CONTRACTOR INSTALLATION ONLY B. 'Services or Feeders ftx;b PI':> I..ev l:Ls.dIC; c,. ~~ Installation, Alterations Electrical Contractor or Relocation: ... ............ ... -~- .,-.. . DEVELOPMENT SERVICES DEPARTMENT Address / tft) /(/ ~e.. tu'1 IJ Vr:.-- City/ZUy--'; Phone h~~7t;73 Supervisor License Number ~~ 1 t) S Expiration Date I()-I- '1 '7< Cons t r Con tr. Number q,,!- 7 _~ Expiration Date 1-l...S--Cf'6 ~p:;Zlectrician Ovners Name \=lIt-tHO ~ .~O 0 Address \ D [) \..~)\/ 'l4'L~ Ci ty Yl ~ <L Phone OIlNER INJrALLATION The installation is being made on property I own which is not intended for sale, lease or rent, Owners Signature: --------------------------------------- DATE: l:l - ~C; - C;-, RECEIPT II. .JCf, ~"S-:l, RECEIVED BY: ~ Temporary Services or Feeders Installation, Alteration or Relocation 40 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only C. 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 D. Branch Circuits 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 $ um $ 15.00 $ 40.00 '.' $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 \ $ 40.00 $ 55.00 $ 80,00 see "B" above volts New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 '\ not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40,00 $ 40.00 $ 20.00 $ 36.00 U() .f'JO /2 ,()() n .() () 7,'{{J'e