HomeMy WebLinkAboutPermit Electrical 1995-4-24
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SPRINGFIELD
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The lol!owing p'olectt ~~~~ir:.peclfiC land use
zoning. aoO does no
225 FIFI'D STREET approval. . {lit :r:
SPRINGFIELD, OREGON 97477 Zoning, ~
INSPEcrION REQuEsT: 72~_~.-.cr'"
OFFICE: 726-3759 D.e_ I I
,IV 'f'^.
AuthorIZed Slgne!U",
1. LOCATION OF INSTALLATION
4343 /!Jot'n 51-.
ELECTRICAL PERMIT APPLICATION
City Job Number
~5.5;5
J. COMPLETE FEE SCHEDULE BELOII ~
A. New Residential-Single or ~
Multi-Family per dwelling unit,
Service Included:
Items Cost Sum
LEGAL DESCRIPTION
/7--&:>Z--32--?J/. ..,:?~/
/
JOB DESCRIPTION
--Ri!JQ(.t biSh, Flour'. uJ/~q~~S
Permits are non-transferable and expire
if work is not started wi thin 180 days
of issuance or if,work is suspen~ed for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor l;;dGSOfl. E/@.(.-frI~/1nG'
Address P-o. Box ,27
Phone qqlr -SSL./8
Number 3'iJ1 S
I().-I~ ql
Co!'st.r Contr. Number qe;'!oy
H,.- 9<1
Ci ty ::riJncfion (,'-Iv
,
Supervisor License
Expiration Date
Expiration Date
O\INER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Ovners Signature:
DA~E~-------~-~-~-~--------------
RECEIPT jI: /7/~ ~
RECEIVED BY: / ,...d:#f
/
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
$ 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
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
Signature of Supervising Electrician
~~L"~~
r' ~ _ _________' D. Branch Circuits
Owners Name~ ~C.~/? ~~ "'"').
'~ . ' New, Alteration or Extension Per Panel
Address 4~'To ./ '7~.4f?' .fI
L__ ' _./.. One Circuit $ 35.00ol.l3'3.00
Ci ty~ ~~L?;) Phone "?Y? ~.:2:::2yg Each Addi tional
. . Circuit or with Service
or Feeder Permit ;l
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36,00
5. SUBTOTAL OF ABOVE ~~. ~
5% State Surcharge . J .''!Jii'~
3% Administrative Fee /, / '7
TOTAL '7''2.. /:c.
volts
$ 40.00
$ 55.00
$ 80.00
see liB"
above
$
1,00
2.00