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HomeMy WebLinkAboutPermit Electrical 1996-7-22 '. Zonina (ll J 225 FIFTH STREET Date..:J''7:1..q(p SPRINGFIELD, OREGON 9747Jl.~S1gnal INSPECTION REQUEST: 726-3769 uro OFFICE: 726-3759 ELECTRICAL PERMIT APPLICATION ,.. .,' Job Number Ul~l) / (J() ,~, unit. T '4Y\ COMPLETE FEE SCHEDULE BELO'\l 3. 1. LOCATION OF INSTALLATION frY) I Marl? ..51-. LEGAL DESCRIPTION \1 (\ "-71J'?41 ~ '?f71JO New Residential-Single or Multi-Family per dwelling Service Included: . A. Sum Cost Items $ 85.00 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder JOB DESCRIPTION o rJ A -m .see u. ~ / fy -1 <rI:tiJ:J Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. $ 15.00 $ 40.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations Electrical Contractor Son i trol SeclJr; ty or Relocation: $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 \ Address P.O. Box 21009 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 Phone 461-5678 City r:lJuene Supervisor License Number /68'9 ~ET Expiration Date /!)-/-qc-, C. Temporary Services or Feeders Installation, Alteration or Relocation Constr Contr. Number 65149 $ 40.00 $ 55.00 $ 80.00 see liB" above 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts Expiration Date 6-28-96 Electrician Signature of Supervising .;:::?d~ Branch Circuits I'D. tllariy &,grc/ ' Owners Name Spr""3 fie/d Address St2 W7.f' Ci ty Phone 7 Zvr Z39fi New, Alteration or Extension Per Panel .$ 35.00 One Circuit Each Additional Circuit or with Service or Feeder Permit $ 2.00 OVNER INSTALLATION E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20,00 Limited Energy/Comm --L-- $ 36.00 ~ 5. SUBTOTAL OF ABOVE 3&' 0'0 5% State Surcharge I ~CJ 3% Administrative Fee J Oii' TOTAL ,:;:g.W The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~~~~::l~~-~~------------------- RECEIPT #: ( r~ !!:":C);~JJ RECEIVED BY: n TY1~.h" \rYAJ