HomeMy WebLinkAboutPermit Electrical 1995-2-23
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225 FIFTH STREET Zonino W
SPRINGFIELD, OREGON 97477 <"
INSPECTION REQUEST:, 726_~U--Z, '] -t) ". ,
OFFICE: 726-3759
Authorized Signaturo
1.
LOCATION 1\ OF .;mSTALLATION
18 4-0 ~ I'ln-UY\J
LEGAL: DESCRIPTION
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JOB DESCRIPTION
-1no a NVl~_~.1i\!.!!..e.Q.l.~_J fi (,ltl.1J .
Permits ~re non-trans~e;able and expire
if work is not started within 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical contractor$BOI'-t; In ,/\1r11L
Address ~,f), ~'1' /4--.J..-:J.-.
City~l)~I~rtJ Phone~
Supervisor Qicense Number I b2/n S
Expiration Date
Ib-l-qS
03<2 t.Jq
Q-/-if5'
Constr Contr. Number
\
Expiration Date
Signature of Supervising Electrician
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Ovners Name_R~ormnftl) .~
Address p, O. BrrL q it
Ci ty lll<l \tlr\-\;{ a a ~ 1 Phone~ b <ti4-3
O\INER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
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DATE: 'j!. "2...,. 9e:::-
RECEIPT 11: ~4~
RECEIVED BY: ~ .
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ELECTRICAL PERMIT APPLICATION
.~ City Job Number ~.c::'/"::>*
NM- - '
j. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular 'Dwelling
Service or Feeder $ 40.00
~
Sum
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
.'
50,00
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
D.
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 "B" above
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New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit 5
$ 35.00
$ 2.00 to.OD
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not ineluded)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
100., no
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