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HomeMy WebLinkAboutPermit Electrical 1995-2-23 , . 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 /?7It>;1- "3'&,.~ c;..-<.. ,~~C> / 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 /7/,...//0 /~~ ~-' .' / 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: ------------------- DATE: 'j!. "2...,. 9e:::- RECEIPT 11: ~4~ RECEIVED BY: ~ . , - 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 .' 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 8,0(') \. ~{'1 ..-b...'l- . .s\ ()