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HomeMy WebLinkAboutPermit Electrical 1994-8-16 .e 225 FIFTH STREET Zonlnp SPRINGFIELD, OREGON 97477 ~~ INSPECTION REQUEST: 726.J3iil69 I I . OFFICE: 726-3759 Authorl18d SignatUre . SPRINGFIELD g'...-llP/tj If 3. COMPLETE FEE SCHEDULE BELOV City Job Number 1. LOCATION OF INSTALLATION <'8'03 ~~p.) S;; A. LEGAL DESCRIPTION 1'\'2. L \ tJ)J 11;~~.r:JJ JOB DESCRIPTION A-fJI) C'J:A.LLL$T J7R.. 2C1.A- - a ouTUZT Permits are non-transferable and expire if work is not started within 180 days of issuance or if,work is suspen~ed for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical ContractorSf'~JtY ~J;!"rJ;..r... Address ?S"J? I ~S.z:;oC f)~M[,.r Ci ty S~ Phone, r773 - 3,}3-~ Super,visor License Number 2S-i/O S Expiration Date Constr Contr, Number ~~~~l/ Expiration Date OZ.::::;?~idM Owners Name /JaR " I?~ &~J Address / ~/,? CA-"I :J::-7C1L ~ ;;;AJ.L. # Ci ty Skr.-. ?7Jt1s P~~ ~~~--,S-4<1,I OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -----------------~-------------------- DATE: ~:'" -':';f ?s-17-9t.f . RECElPT #: -7 .' ~~,~ I "3~ 'Z. RECEIVED BY: W. '" New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cos t Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 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 D. Branch Circuits New, Alteration or Extension Per Panel L 3r $ 35.00 One Circuit Each Additional Circuit or with Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL 3S; (7(7 I , ">-.r' { .Il~ '? 1> . &'-0