HomeMy WebLinkAboutPermit Electrical 1995-11-7
__to J
zoning, and does no req
approval. (~ '
Da\.-+(o~il ~ tt ~ A Al
225 FIFTH STREET Authorized Signature ..J,YV
SPRINGFIELD, OREGON 97477 .
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
~Lo~aTION OF INSTALLATION
r-- :serOO MA1 A) sr
(' LEGAL DESQUPTION n O"L s I 3. I
.C:> f"1'Z. I .0 ~ 1--1 1::'-7) ,...,'" 2,Im
JOB DESCRIPTION ';:>-....1
A-nD eN E' , I \ ' - F2-
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY ,B.
Electrical contractor_'1? ~ (t\0 Dfrl' ELI;"
Address Lf 2.. 7 fCO'b./'r-Lf::" J:J CZ ,
City EY/-C Lt: f"IPhoneSt{ 7- '??a'fF-
Supervisor License Number .:s c; / I.( S
Expiration Date ~ J//7 J??
Cons tr Con tr. Number 'if ( 0 f (
Expiration Dat,-~~A .~~ oJ/n/7?
Signature of Su~ising Electrician
~~
Owners Name ivA-i.-L f-' (C,u{q,f-J
Address :s yo 0
Ci ty.5 f'Je. (.->, ff~L!J Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE;-f\-:'-~::-~~------------------
RECEtPT #: U~ q ':::> l- 4
RECEIVED BY: _N. T 'It P<<!..-H -Af)()
. ..,';"
/
~~~CAL PERMIT APPLICATION
City Job Number
<15002....1-
3.
COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
unit .
.
Items
Cost
Sum
1000 sQ.ft. or less
Each additional 500
sQ. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
~
.so'
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see liB" above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$
$
$
$
,~ 50.lfb
. 4.Sc.
1.50
~
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
/