HomeMy WebLinkAboutPermit Electrical 1996-4-8
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SPI:F;~LD
Th. following proj ct
zoning, and does ~ot ~:,~~bmlttod heath. fo!!-
approval, _~u re epsclfic land ueo
Zoning ~clJu
225 FIFTH STREET 001. L/ -~ -9 &
SPRINGFIELD, OREGON 97477 11 _ /l
INSPECTION REOUEST: 726_3~rlZ&d SJgnatu"'~
OFFICE: 726-3759 1
3.
ELECTRICAL PERMIT APPLICATION
City Job Number 9LO';r3~
.,
COMPLETE FEE SCHEDULE BELOV
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unIt. ,.~,
1. LOCATION OF INSTALLATION
&"57~ r-4#/N' '57' .
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
A.
LEGAL DESCRIPTION
I"?~O-;;Z --=3</-41:2...... c~"3~S-
Sum
Cost
Items
1000 sq.ft. or less V-- $ 85.00 ~
Each additional 500
sq. ft or portion
thereof ,'2 $ 15.00 ~
Each Hanuf'd Home, or
Hodular'Dvelling,
Service or Feeder $ 40.00
JOB DESCRIPTION
IAh-r-:J/~ ~/"f" ?r ~.
, ,
Permits are non-transferable and expire
if vork is not started vithin' 180 days
of issuance or if vork is suspended for
180 days.
,B. 'Services or Feeders
Installation, Alterations
or Relocation:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~/~ ~
Address 1130 -:EJeu N;jJ fd. =#21./,
City~e Ihon$llI-3L/L/ 5315"'
supe~iso) License Number ~b/~-~
Expiration Date IDII /q~
Constr Contr. Number blo';?'l4
~ /2$ !'fro
S 50.00 "
S 60.00
$100.00
$130.00
$300.00
S 40.00
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
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
S 55.00
S 80.00
see "B" above
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
Expiration Date
Signature of Supervising Electrician
':!:Q
~
- . a . D
Ovner Name ;?,f"~?'v 4~~~"=--.}-- - ~
Address ? V/) ~/.;<:;7.
City ~P~Z>_~.~hone /L~-:::?~2.3'
, '~?C;?9
OVNER INSTALLATION
volts
"
"
Nev, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or vith Service
or FeedeL' Permi t
"
S 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
Limited Energy/Comm $ 36.00'
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
,
Owners Signature:
//~<>e>o
~ - '/:> -
? V-=>
/L't.'-?~
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
--------------------------------
DATE:_ t./-~-'"?C
RECEIPT 11: -::2.?'7$:'37
RECEIVED BY: /,1~-=--