HomeMy WebLinkAboutPermit Electrical 2001-7-26
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The following project as submiUed has the tollowing
zonlng~nd ~oes not require specific land use
approv., 11 A D1?
225 FIFTH STREET Zoning IVVV~ . ELECTRICAL PERMIT APPUCATION
SPRINGFIELD, OREGON 97477 '7~OI
INSPECTION REQUEST: D3}~~; 'PI).. . City Job NW1JberO/~007L(<J-,OI
OFFICE: 726-3759 Authorized Signature' ' liI\
3. COMPLETE FEE SCHEDULE BELOY .,..J.__'~?l
1. LOCATION OF INSTALLATION - - (
i'P5f?C; main Sf. A. New Residential-Single or l7J,-- \.
Multi-Family per dwelling unit. IV,
LE~AL DESCRIPTION Service Included:
(702... 3LtI./t./ 0/ I 00 Items Cost Sum
JOB DESCRIPTION
insfall Sf'J'.ur,'+u
i
Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Son it ro I Secur j ty or Relocation:
Address P.O. Box 21009
Ci ty Euuene
Phone 461-5678
Supervisor License Number /(Pgej R.ET
Expi ra t ion Da te
/0-0(-01
Cons tr Con tr. Number 65149
Expiration Date
6-28-00
Si~ature of Supervising Electrician
0A'~
Ovners Name Dale /2; ~(/anr-
Address &5Jt:j rn:ll'fl sf.
Ci ty Sorfna,fifld Phone 7~0 -5?~& 2
I J
OVNER INSTALLATION
/
The installation is being made on
property I oun vhich is not intended
for sale. lease or rent.
Ovners Signature:
---------------------------------------
DATE: 07/ '80 (
RECEIPT #:
RECEIVED BY:
utl
~\ / ~
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
S100.00
$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
D.
Branch Circuits
Nev, Alteration or Extensiort Per Panel
S 35.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigatiort
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
'7. State Surcharge
37. Administrative Fee
TOTAL
$ 40.00
S 55.00
$ 80.00
volts see IIB't above
$ 2.00
not included:
S 40.00
$ 40.00
S 20. 00 d-l'J'TP
S 36:> 00
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