HomeMy WebLinkAboutPermit Electrical 1996-10-25
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Th!} followinQ proj'9ct as ~ubmitt:::li; M,.othe foll~)\nlng
ZO~il\g, and doec not roquire spt\Cl1ir. lend uso
225 FIITH STREET epproval., f U
SPRINGFIELD OREGON 97477 Zonmo '
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INSPECTION REQUEST: r..7..:f_6-3769/0-b'ry
OFFICE: 726-3759 Authorized Signature fl.yYL- ~
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1. LOCATION OF INSTALLATION
/.:J57 711a ('n .sf
ELECTRICAL PERKIT APPLICATION
9G 1%3
City Job Number
~vnrLL!L FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling
Service Included:
A.
uni t.
LEGaL DESCRIPTION
l~ 6' .s c:; ""/ I
f) K{/J (JD
Sum
Cost
It ems
$ 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
i n.<,-h II ,<;er- 1..1....l::..L..+V
I
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
Electr'ical Contractor Son it 10 I Secu Ii ty or Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Address P.O. Box 21009
Phone 461 - 5678
Ci ty Euuene
Supervisor License Number /to'8Q t<.ET
Expiration Date 10-(- q9
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number 65149
$ 40.00
$ 55.00
$ 80.00
volts see "B" a~
or less
to 400 amps
to 600 amps
amps or 1000
200 amps
201 amps
Over 401
Over 600
Expiration Date 6-28-96
Signature of Supervising Electrician
~~;d?~ "
Owners Name OnJnn -dm; sJudy Tnsf,~k
Address ~ me..
Ci ty Phone 744- ;~P82
OVNER INSTALLATION
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 2.00
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 ~ $ 36.00 ~noz)
5. SUBTOTAL OF ABOVE 3Co CTD
5% State Surcharge I SO
3% Administrative Fee I o~
TOTAL ~ '6' ... ~
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-----.-----------------7:.- --------------
DATE: 10/2-) J't:?
RECEIPT jI: / "2.' i./l'l
RECEIVED BY: ,.6"/"7...
/t' 7- '1