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HomeMy WebLinkAboutPermit Electrical 1994-9-26 - . The following projocl as .ubmltted h.. the following zoning, end does not require specific land use 225 FIFTH STREET approval.' ELECTRICAL PERKIT APPLICATION SPRINGFIELD, OREGON 97477 Zonina <:.-V INSPECrrON REQUEST:, 726-3169," -"1L-{ OFFICE: 726-3759 Deley-'2.", 1. LOCATION OF INSTALtltt.f5if Signature tJ "",3. L{ =';O}) M-n f'V'. ~ 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders (\,... ~tv... _\ C~ ~~ Installation, Alterations Electrical contracto~Oo.~ r X O_l..:-i or Relocation: Addres~ ~ J\C\..Ull- ~~ 200 amps or less .a.. \ (\ - '^ 0 201 amps to 400 amps Ci ty\.J "\ '\f)\ 'e..... Phone _ . I. 401 amps to. 600 amps - r)-:2f\() C" 601 amps to 1000 amps Supervisor License Number " )~ )- 1 t..-:) Over 1000 amps/volts ,\ ~ \ n r1 Reconnec t Only Expiration Date \ \ ). ''-''\ l . t:::\ _n II n C. Temporary Services or . Feeders Constr Contr. Number ~lCTL-' I --\ Installation, Alteration or Relocation Expiration Date ~ .c:J\~ 200 amps or less $ 40.00 201 amps to 400 amps $ 55.00 ignat~of~perViSing El7;r'cian Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above AFV _ . /' r l'~~ . D. Branch Circuits Owners Name \J\ \1l1 \t::L (I New, Alteration or Extension Per Panel Address \('1\~~, ~ Ci ty r.l ~ Phone OVNER IN~LATION LEGAL DESCRIPTION l7 02...- =)2-- '? I () ?_LtJD ~ N\r\^-DW.E)\~'f(1 C1Z/ perm;t~are non-transferable and e~ire if work is not started within 180 days of issuance or if work is suspended for 180 days. The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE~----------t\~~1lJ-1J\~---~-~--- RECEIPT 11: ~ _ ' A~~ RECEIVED BY: ~ lJJ""' City Job Number qLj M73 A. COMPLETE. FEE SCHEDULE BELOV New Residential-Single or ~ Multi-Family per dwelling unit. _ ' Service Included: . ",' ' Items Cos t' Sum $ 85.00 A~ 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular. 'Dwelling Service or Feeder \ $ 15.00 $ 40.00 $ 50.00 $ 60,00 $100.00 $130.00 $300.00 $ 40.00 ~l) .. " $ 35.00 One Circuit Each Additional Circuit or with ServiF~ or Feeder Permit \l) $ 2.00 ~D~ E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lightin~ $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE l~~~ 5% State Surcharge ~.1l,\ - <\ ~~T~ministratiVe Fee /ID' I.~