HomeMy WebLinkAboutPermit Electrical 1994-7-28
.
~~
Tha fOllowing project
zoning. and docs not ~eqS 8~bmttted. hac the followi
approval. ulfa specific land usa
ELECTRICAL PERKIT APPLICATION
225 FIFTH STREET II / I
SPRINGFIELD, OREGON 97477 Zoning l-L/
INSPECTION REQUEST: 725Jdi1697-1. K-,'f
OFFICE: 726-3759
Authorized Signature /J fXJ-:
1. LOCATION OF INSTALLATION
-e. ~'l / ,'\/7/r77"')
LEGAL DESCRIPTION
)7/92- ~:2, d:L /) ~ "?())
JOB DESCRIPTION
-./ r<;- Z2H? A"7t:b:l.f r
, .
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name 6' Cin )t<- ~f'2,../ .-/
Address /~ O~ &/'X ? /
City ~.R{/OW Phone 72&-6.(01
'7?~q.2-
011NER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
--;;
,.J?:i.~ ~
~~~~~-:~------~~~~~-----------
RECEIVED BY: ' ~
. .
Ci ty Job Number 9" 2/11' S-
COKPLETE FEE SCHEDULE BELO\1 *
New Residential-Single or " .
Multi-Family per dwelling unit. "
Service Included: "
A.
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
20l amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over lOOO amps/volts
Reconnect Only
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 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 lOOO volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see ttB" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit ~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00 h.<fH>
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
0,0-0
'-z~
110
C, 4fJ.