HomeMy WebLinkAboutPermit Signage 1994-6-14
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SPRINGFIELD
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225 FIFTH STREET 7on,,'1.. _ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97471 (i-\/i--rr, Q ~
~~~~O~2~~~r: 726-3~~.:,~~:(:._\ih_. City Job Number_ 71!7~35'
1. LOCATION OF INSTALLATION 3. COMPLETE FEE SCHEDULE BELOV ,*..,..._
_')gqlJ.. t11l:lit\.~ c::;1: . -, -:: Z A. New Residential-Single or
Hulti-Family per dwelling unit.
LEGAL DESCRIPT~QN. Service Included:
.A&u "517'" Hoot.. I /j'
JOB DESCRIPTION_
4~i '1t1~// C,!C'5isflNJ
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical contractor~rf)
Address_/R~ltb '":&rrt-lrYr 41 Rd.
City LOrl'tfLp Phone9....,'-/IJ..- J05Q
Supervisor Licen.se Number 53?,.<) .1 (2
Expiration Date 10..- I -<ft..
Constr Contr. Number qlJ. f& (1 R'
Expiration Date J -'11.. - 9t-/
~~=~u~k:tectrician
;, Owners Name <) cl +I- . ~ ()~/ c:;
Address? '7 ,~'i '-&rl'f.N~ (/
City furV1~ Phone (cR)-fHb7
OVNER INSTALLATION
The installation is beirig made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
--------------------ti2-~-----------
DATE: /..//' r7~
RECEIPT #: - I /:l 42'")
RECEIVED BY: - .if~-
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd Home or -
Modular Dwelling
Service or Feeder S 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
$ 40.00
S 55.00
S 80.00
volts see "B"
above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting~
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$
$
$
$
k~
4/) coo
.
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL ~....... S'?o
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