HomeMy WebLinkAboutPermit Building 1996-10-23
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225 FIFTH' STREET 'Authorized Signalur.--1L"A
SPRINGFIELD, OREGON 97477 ' .
INSPECTION REQUEST: 726-3769 '
OFFICE: 726-3759 '
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1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
17 CJ.). '3" 4/
o d30 /
JOB DESCRIPTION ' ,
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Permits are non-transferable and expire
if vork is not started,vithin 180 days,
of issuance or if vork is suspended for
180 days.
_ ELECTRICAL PERMIT APPLICATION
Ci ty Job N~ber Q,4z I 4'-i C(
,3"
,Nev 'Residential-Single or *
:::::::.:: ::~::,::~:";,. , . '
Service Included:
Items Cost Sum
. A.
1000 sq.ft. or' less
Each additional 500
~q. 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
Electri<;al Contpactor ,y~<;F RR'Z6r Relocation: , ' ,
'Address /12JX /dlh~ 200 amps or less
. " 201 amps to 400 amps
City~~hone_,~/-~-c:J$401 am(ls to 600 amps
, ' , ' 601 amps to 1000 amps
Supervisor License Number -4;?~.:s Over 1000 amps/volts,
, Reconnec t Only
Expiration Date ,//J ,..4'~
Constr Contr. Number~~~~~'
Expiration Date
:7- ~;?
Sign7~::;iSZ;*,
Owners Name 7-/1 "
Address ~~t3 ~Al-H}';":r::-
Ci ty ~A.J'.,.An/J Phon~..2!J7": /~
'01lNER INSTALLATION
The installation i's being made on,
property I ovn vhich is not intended
for sale, 'lease or ren t.
Ovners ' Signature:
-------------------c:------------------
DATE:)f) - (1..'3...; -t (p , '
RECEIPT 11: 2~~.;'" ,
RECEIVED BY: (\. ,Y\Q..OIlIAd,O ' , .
$ 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 $ 40,00
201 amps to 400 amps $ 55,00
Over 401 to 600 amps ' $ 80;00
Over 600 amps or 1000 'vol ts see lIBlf above
D, Branch Circuits
"
New, Alt~ration or Extension Per Panel
,One Circuit / $ 35.'00 -:3'5: ~,
Each'Additional
Ci rcui t or vith Service ~,
or Feeder Permit ? $ 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
5, ,SUBTOTAL OF ABOVE
5%, State Surcharge
3%,Administrative Fee
TOTAL
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