HomeMy WebLinkAboutPermit Electrical 1997-3-13
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225 FIFTH STREET nolo '?~U ~&(7
SPRINGFIELD, OREGON 97477,,1t lodS'gnatur. NI'^
INSPECTION REQUEST: 726~3/~if I
OFFICE: 726-3759
ELECTRICAL PERMIT ,~PLICATI~N 3'
Ci ty Job Number Vf 703:0 'At
'*
uni t.
3.
COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
1114- .vit'\1,.J $, A.
, I 7e&3~ ~L~dJ'P1{6N
ifl:i?~L11t 'TV"\'J ~
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
Items
Cost
Sum
JOB DESCRIPTION
WII"tG o~?6 - t.0l1ZE f7fmt[?a?M'7
1000 sq.ft. or less
Each, additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular'Dvelling
Service or Feeder
$ 85.00
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for'
180 days.
2. CONTRACTOR INSTALLATION ONLY ' ,B.
Electrical Contractor~W Gu:;un'Z1&
$ 15.00
$ 40.00
Services,or Feeders
Installation, Alterations
or Relocation:
Address,?-I C70
,
C i t y J;;.v C1;JJ IZ
13v?1i .':;''1.
Phone 4134-,2.7B
200 amps or less
201 amps to 400 amps
401 amps to, 600 amps
601 amps to 1000 amps'
Ove~ 1000 amps/volts
Reconn,ec t Only'
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Supervisor License Number '2-tj ~c; '?
Expiration Date It/ -7yJ -<1 fj
Cons t r Con t r. Number A-i;;'ll
Expiration Date '1 ~ z..e> -?J.t)
C.
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
$ 40.00
$ 55.00
$ 80.00
see "B" above
!J;;~a~iCi~
O"ners Name .\1 forJ l'1/2Iru::LUevL-
Address /1iL/ fvJlt,/V
B'ranch Circui ts
D.
.'
Ne", Alteration or Extension Per Panel
$ 35.00 ?/i.UO
$ 2.00 L(.0tJ
One Circuit
Each Additional
Circuit or "ith Service
or Feeder Permit L-'
City ~PM
Phone
OVNER INSTALLATION
The installation is being made on.
~roperty I o"n "hi~h is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder 'not included)
. -Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Liini ted Energy/Res $ '20'.00
Limited Energy/Comm $ 36:00.
. 5: SUBTOTAL OF'ABOVE :'31tJ{)
'! ~~~~~.:~~-:~-=i~=-;rT--~':::----:-:-~~:~-~--:--, ,";"',5%. S ta te '~Su:ch~rgE7 '.j' . '-", .. (. C(~. ., ,;. .
" ".RECEIP'f II:. -.: /1I'if'1t? ..)",. ..3% AdmiOlstrat1ve Fee..,.'"., . .1:17. ,,,' .'.,.:
" ,.,. :'RECEIvtD 'BY: . .. I//' '.. .."", ..,., . "''\'''''':TOTAi.,..i--'c.'':'''c.<:.'t~.";,p:""",,, . ''-{''2,''77_' "'.,'.
Owners Signature: