HomeMy WebLinkAboutPermit Signage 1998-4-17
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SPRINGFIELD
(he folloWing project
;~~;~~~rnd does not ~s,;:~e~~m':f..~~ ~~~Iowlng
ZOning!f
225 FIFTH STREET h . ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 DSle'~-\L::fL n 'Y7.....;?-7S
INSPECTION REQUEST: 726-3769thorlzed Signature n tv' Ci ty Job Number vI 0 u :::> /
OFFICE: 726-3759
3. COMPLETE FEE-SCHEDULE BELOII ~
1. LOCATION OF INSTALLATION
)7-1-1 ~.., 9f: A. New Residential-Single or
Multi-Family per dwelling uni t. :
LEGAL DESCRIPTION Service Included:
1,1')")- S'3., I o?,/m') Items Cost Sum
JOB ~SCRIPTION r'J1v (1/&'11 1000 sq. ft. or less $ 85.00
;1.1v i lit /11'1 I ..e~"5 Each additional 500
- ft or portion
sq.
Permits are non-transferable and expire thereof $ 15.00
if work is not started within 180 days Each Manuf'd Home, or
of issuance or if work is suspended for Modular,Dwelling
180 days. Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
J~. Install~tion, Alterations
Electrical contractor-lJ' h4-hLO Jt>..l'lf? or ~'O~ation:
Address J%.k l" '1::Uv";-fov.,' ~ . PI. _j..,~\~~ \~1~ ~~~\r less
I .. ~C'. ^ur.\...\.. 'Co. s ~a'OO" illI\P$ to 400 amps
City ......O,r14Pl4 Ph~:r: J\~~'~~ ~aml's to. 600 amps
~'Co'" ~;.,.. ~~~tl'6oi amps to 1000 amps
Supervisor License ,Numbe~~ ~);.~~ Over 1000 amps/volts -----
~ r;;.'<1<.C~\J ~Otl. Reconnec t Only
Expiration Date 10- I -~~~ tt"~~
~~I) . C.
Constr Contr. Number ql),f,-9!o(5
Expiration Date q-/l./-Cl)?,
s~re of Supervising Electrician
AA;', \))0
Owners Name(Y\<2..t'of\1..'!I _ Cf!.D5:)~ ~(O GrD'
i f/
S 5nzeer
Address'120s
City~
tt1-'
Phon(7{f7)q.p -<{(pO I
O\INER INSTALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Owners Signature:
____________________~~-\---- '---~ 5.
DATE: , --r' II'~ \D
RECEIPT 1I: \, ' I t
RECEIVED BY: 'J)\l)C"1_ -I .'\
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "Bl~
above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline'Lighting
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
.. TOTAL
$ 35.00
$
2.00
not included)
$
$
$
$ 36.00
A1)~2
:4~'.~~
l
40.00
40.00
20.00
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