HomeMy WebLinkAboutPermit Electrical 1995-7-18
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The foliowir:O p~r);~(;t;;.-2> !;ll.bI'Y';:::' . .~ ~ th~ iCH..:..win
zoning, and does not requIre ~pitCitlc land usa
approval.
Zonina I /D~
225 FIFTH STREET D~ ' S -('
SPRINGFIELD, OREGON 9747JUl.tl>>p;.edSignatura l\/'vV\.
INSPECTION REQUEST: 726'~j/b'j
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
L{ M I 111/ VP'.tJ/l I"> V1
C/ LEGAL DESCRIPTION 0-
j /'J tJ2 D5 2--1 01'\ f("{) ~
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number q c; Il.- 0 I
3. COMPLETE FEE SCHEDULE BELOII
A. Ne~ Residential-Single or
Multi-Family per d~elling unit.
Service Included:
JOB DESCRIPT.JO~
/L,n!cr.1i" ff1a.b.,I....).,,,.-rtQ Jl,~ i- ?(~
Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
Items Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
. Installation, Alterations
Electrical Contractor fY.,."", ~r>l", 00 ~'C r,..,or Relocation:
~ . J~.
Address ~)I? R "" ~ ~~":J, J ~ nr j..,,,, r1 (' ,,'/-.., . 200 amps or less
r. . . ~ 201 amps to 400 amps
Ci ty~,.,}'~"I-t,.' 9 IC(~ Phone c,qq - "',6'-/ '1 401 amps to. 600 amps
/ 601 amps to 1000 amps
Supervisor License Number Q 7~~ ~ Over 1000 amps/volts
Reconnect Only
Expiration Date tf/9'5
Cons tr Con t r. Numb'{\. .J. ()
1<1'''. c:
Si
Q07:'J5
lectrlclan
$19~
-~t
O~ners Name f\.J."""<"
42Jb,t
;::;0 r -J ..t2
In T //f'f;?{'7 r1_
Phone /4 ') - '710 t:t
Address
-,
Ci ty ~ 8' r 'r77c./. o't)
t.(/
O\INER INSTALLATION
The installation is being made on
property I o~n ~hich is not intended
for sale, lease or rent.
Owners Signature:
-----~----------. ---------------------
DATE: (-I k .....9S
RECEIPT 1I: 0/ 7~'.,l~ () .
RECEIVED BY: j...J ~~ ~
$ 85.00
$ 15.00
$ 40.00
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
D.
Branch Circuits
$ 40.00
S 55.00
S 80.00
see "B" above
.'
Extension Per Panel
-1- $ 35.00 ?>~
Ne~, Alteration or
One Circuit
Each Additional
Circuit or ~ith Servic~
or Feeder Permi t --L-
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
2
2.00
not included)
S 40.00
S 40.00
$ 20.00
$ 36.00
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