HomeMy WebLinkAboutPermit Electrical 1996-10-18
.
. . . s the following ,
. t as subTllittod.h3 \ nd u9ll'
1he following prolenCot reQuire Spec~IC a ,
. d does
; Zf)f'\lng, an ,. f)./J-
approVo\. ~\J'~
225 FIFTH STREET loning~
SPRINGFIELD, OREGON 97477 ~lb/'1V
INSPECTION REQUEST:O"t'l.26-;!?69' ~, . 1"-
OFFICE: 726-3759 "'2 eciSignature-
AutnoT
ELECTRICAL PERMIT APPLICATION
-City Job Number 9(;;J1/$Q.
Nev Residential-Single or ~
::::::.:: :::'::~:'i'. ~ .
Service Included:
3.
1. ./LOCATION OF INSTAL~ION
(g/t.(q /tlllilf "'5f ~/
LEGAL DESCRIPTION
J7 0). '3 '13 if 1'/[)5 r77::>
J9"Jl DESCI\CPTI.oN .
~IV arl:uJz...
".
A.
Items
Cost
Sum
$ 85.00
1000 sq.ft. or less
Each addi ti"onal 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .Dvelling
.'Service or Feeder.
'I
$ 15.00'
Permits ~re non-transferable and expire
if vork is not started vithin 180 days
of issuance or. if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
$ 40.00
Service~ or Feedeis
Installation, 'Alterations
or Reloca t ion: '
.B.
Electrical Contractor;;+lt1't.-€'R'JJ ~~V
Address 7.-/r;;~ !;tlt1? $'1
Cityftv~~~ Phone. LfSt.f"11-7tg
$ 50.00
'$ 60.00
$100.00
$130.00
$300.00
$ 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
Reconnec t Only'
Supervisor License Number 'J-.'11-~ S
Expiration Date. 10-( - "1,
Constr .Contr: Number 41';1 (
Expiration Date '].--; ~ q 1
C. Temporary Services or Feeders
Installation, ~lteration or Rel~cation
$ 40.00
'$ 55.00
$ 80.00
volts see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
1;;;:;;;:eo:s~an
'o~nersNamem~/UJ~~(L a-~ D.
)
Address -;q 5;l:~1 ,J:obN- ~ p / '
CitY(o/k;'f~tflhone1t(2- 72 ~
OYNER INSTALLATION
Branch Circuits
.'
Nev; Alteration or Extension Per Panel
. $ 35.00 -?~
One Circuit ~
Each Additional
Circuit o~ vith Service
or Feeder Permi t' .;;;;
, /~
$ 2.00 0 . .
E. Miscellaneous (Serv1ce/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Li~ited Energy/Comm $ 36.00
5. SUBTO:rAL OF ABOVE 'YI1lD.
5% State Surcharge
3% Administrative Fee
TOTAL.
The installation is being made ,on
property I ovn vhich is not intended
.for sale, lease or ~ent.
Owners Signature:
------------~7.f-----------------------
DATE: 10-1 V-'t& .
RECEIPT #: z?,t7n
,RECEIVED BY:--k-