HomeMy WebLinkAboutPermit Electrical 1997-3-10
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Tha foJla.vlng project 88 IIUbmIIted heIllhe foI
zoning. and doee not require epeclfIc: land U80
approval.
Zonlnp (' {'
Oate'2,.... K),-er; ELECTRICAL PERMIT APPLICATION
97477 AUlhu,lz8cISllllllltl '" (\ vv.. ' ,
726-3769 ~' ' Ci ty Job Number q 7 I., d..-L/.-
~ ~~OMPLETE FEE SCHEDULE BELOI/ "Yfj.,
l....,.,..L...oCATION OF IN~TALLATION -?v)') il'~ ~. ..
A~ lNt"',1I\ 3-rlPl) :- CO.. ~$%N\;i'" Residential-Single or &;:;. .
"J).. -~ ~ ~l ti-Family per dlolelling uni t. '- '
~ ~ ~ ~vice Included:
<1 ~ ~~,
'/- Q ~ "<~
~ :fSI#~~ ft. or less
~ ~c~~ ~tional.500
. ~ ~portlon
t e~. ~
Each a~~'~~?me, or
Modu "'h~~~ng
Servic~o~eeder
2. CONTRACTOR INSTALLATION ONLY B, Services or Feeders
, 'I( 1 Installation, Alterations
Electrical ContractorC8::x.J~ ~j ~(ed1.c. or Relocation:
Address 9.D t&x ~d;;}C) 1 . 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
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPE~rION REQUEST:
OFFICE: 726-3759
LEGAL DESCRIPTION
17 0 Y;:,' '-/-'J-
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if IoIork is suspended [or
180 days.
Phone .f!1J 55r'~3Fb(
License Number 3COd-LI-5>
Ci ty F~.ev-Z..
"
SupeL'visor
Expiration Date (d~
i
Constr Contr. Number' ~~;'~
Expiration Date. f'~
Signature of Supervising Electrician
//I~~A-~-
~:ners Name 4)e.1f t V~ if '
Address J.. q 0 'P{i.-~ '
Ci ty..lJJ. d-'>( ~ Phone Ql{;).-..1.1o ~ I
OIINER IRsTALLATI~N
The installation is being made on
property I ololn IoIhich is not intended
',for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT D:
RECEIVED BY:
':C-IO - "\7
..2C,O'5!)
c.:P')u.)
Items
Cost
Sum
$ 85.00"
$ 15.00
$ 40.00
$ 50. ort fiL-
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
D.
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80.00
see "Bt! above
"
Nelol, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or IoIith Service
or Feeder Permi t 10
$ 35.00
$,2.00'~
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
if//), --
-t ""~O
, ~...l!6
'F- (po
40.00
40.00
20.00
36.00