HomeMy WebLinkAboutPermit Electrical 1994-9-26
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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.~