HomeMy WebLinkAboutPermit Electrical 1996-9-13
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225 FIFTH STREET Zoni C,C
SPRINGFIELD, OREGON 97477 ~
INSPECTION REQUEST: 726-376g,g. L'b .q-f(J
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job Number C\ 1!))1Jf)
".~r-...,.u PBB SCHEDULE BELOY
, ,":hortzed Signatu,.
1. LOCATION OF INSTALLATION
'Vi\\o.Se, s'q\X1re, SYI'S MA\~ ST SPltIN("fig.DA.
\10t3~~OtBmD
JOB DESCRIPTION
\ (\ ~ y.. \ \ \l \ \llVid'\ t:\ \uI {:,.( ( <; mnili.Cl-:f' '\ ~/,
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 ES-t.A, I"-Ic.
Address \2:\0 OAKPf\TU-\ (ZOA\:)
Ci ty tv5e()-~ Phone Ll8S-SSLjl,.o
Supervisor License Number Lll.\S S I <0
Expiration Date \()~ \ - C\\p
Constr Contr. Number \ \ \ Z-'2,~
Expiration Date 12.- '2,-'1'1
s~erViSing'Electrician
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Owners Name..0('A't"n"'l ~ d. p..'S~Ot\ 1\ J:S
Address. '2D1. ~W (,,+1-1
Ci tY(,A')('i (;, \ \ is Phone t"JS4- (D ~L.O
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~----------------t)-~~~J?------
RECEIPT jI: . j, I\""l.}\ ~
RECEIVED BY: rt-.\[;t)YJ\V J.
V)
New Residential-Single or
Multi-Family per dwelling
Service Included:
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
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items
Cos'
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 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "Bit above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
S 36.00
4\).CD
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