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HomeMy WebLinkAboutPermit Electrical 1996-5-30 I . The. following project as submitted has the f zOlllng, and doea not require specific fa d 3pproval. n use 225 FIFTH STREET n /'0 ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 Zonina '-.:. '---- Q/ . i\ / L 0, INSPECTION REQUEST: 726-37~~IO.o--n Ci ty Job Number I V;,U ( 7,7-- OPFICE: 726-3759 . .j( Autl\onzod SIgnature 1. LllCATION OF INSTALLATION /qL/() fYJan-ola I<d A. Nev Residential-Single or Multi-Family per dvelling unlt. Service Included: Items Cos t .um j -/:13 D~s5~N OO/6D JOB DESCRIPTION /nsla// SeCu.Y/~1 Permits are non-transferable and expire if work is not started vi thin 180 days of issuance or if york is suspended for 180 days. 1000 sq.ft. or less Each additional 500 sq, ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 85.00 $ 15,00 $ 40,00 2, CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations Electrical Contractor. Son i t rol Secur i ty or Relocation: \ Address P,O. Box 21009 Ci ty Euuene Phone 461 - 5678 Supervisor License Number jt,'B'1 f(&T Expiration Date j/}-j- 9'~ Constr Contr, Number 65149 Expiration Date 6-28-96 Signature of Supervising Electrician 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 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40,00 $ 55.00 $ 80,00 see "B" above Oyners Namtri-~~-:r1tCI:;X1 t~/s~ D. Branch Circui ts If? 'tF.l fi5~3o fLn..e 0Ro"u.,d)ey, Alteration or Extension Per Panel ,"CO" "K E ,,_c' "'1;7' ~o/q I 7'ftD One Circui t .$ 35,00 Ci ty ~'~"jP Phone _ Each Addi tional (p '67-2 / Circuit or yith Service OVNER INSTALLATION or Feeder Permit $ 2,00 The installation is being made on property I oyn yhich is not intended for sale, lease or rent. Ovners Signature: --------------------------------------- DATE: ,..l)- 3D- ~(d RECEIPT~#: O~ /-7 j (J RECEIVED B'y: r). i'n ci)~ 0 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 Ener.gy IComm ~ $ 36,00 ~&,Ol) 5, SUBTOTAL OF ABOVE ~~.~ 5% State Surcharge !. '80 3% Administrative Fee !.: r? g TOTAL , ~i? ~f?'