HomeMy WebLinkAboutPermit Signage 1997-3-28
The following project as SU, ilhU\;'O....,"'--:.. '-_.,'
zoning. and does not requIre !:itJ'::I.'IlIC l_l"ld U..J
approval.
Zoning (,U
oata2-Z~-<q.
974 71>.uthortzed Signature /J IV'-
726-3769
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
AC.MI=. CnU.\ 510;,] 4050 Me.; () 51-
LEGAL DESCRIPTION
17b 21,2. 31 IY2 ~DD
JOB I}ESctUPTION- --- :::::----"
-, \ h)\'Y\ (VV\ nVlIlVY\en-\ S i~
Permits ~ nnn-transierable-artO expire
if ...ork is, not started vi thin' 180 days
of issuance or if ...ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ES,A . Il-JC,
,
Address \2\D DA,,"-PAiL\-\ ~[)
Ci ty "EA 1M."''' ' Phone l19,,,)~SSYl,,,
J '
Supervisor License Number 'U'O 5 S I (p
Expiration Date 10 I q Cj
/ c.
Constr ContL". Number 1112~te dtJ-265Ccs
Expiration Date2-2-'1R Ilb-I-qi
Signature of Supervising Electrician
/b~ ~d
~</ () u D.
O...ners Name nIl r1 ()d1nSD(l
Address L-t:>50 \V\CA\(\ S\{'e..e.-t
Ci ty Sf(\Y'3\\e...\ d-. PhoneltP>S- D?-J 10
OIINER INSTALLATION '72/,p- IdY-z...
,
The installation is being made on
property I o...n ...hich is not intended
for sale, lease or rent.
Owners Signature:
-------------------nc------------------
DATE: J~a,:l,
RECEIPT #: ,1, -:.~_., -,,~
RECEIVED BY: ~ f.7- ,
ELECTRICAL PERIlIT APPLICATION
City Job Number QlD~~
COMP.LETE FEE SCHEDULE BELOY *,
-'
Ne... Residential-Single or '
Multi-Family per d...elling uni t. ",'
Service Included:
Items Cost Sum
3.
A.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular, 'D...elling
, 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
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 liB" above
,
.'
Ne.... 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 vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
.'
$ 2.00
. "
no t Included)
. !.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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