HomeMy WebLinkAboutPermit Electrical 1995-4-12
15n.
SeGFIELD " ,,', .
, bmltted has the fellowi ,
The following projoctt89 .9~ire specifIc land use
zoning, and does no req
approval.
Zoninl' M Dt2-
97477 "'I'2--q-)"
726~69 -r -
Authorized Slgnstur, tJ m
3.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job Number qCCf)? 10\
COMPLETE FEE SCHEDULE BELOY
lo~A~~N()~.Nt~LAf~
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A. New Residential-Single or
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq.ft. or less c9. $ 85.00 J!J{)
Each additional 500
sq. ft or portion A 6D
thereof $ 15.00
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder $ 40.00
,B. Services or' Feeders
Installation, Alterations
or Relocation:
. ",JOB D,ESCRIPTION
\.A-.1\ . ~\ o~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTAL
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
~~~~
Number ~{XJ~
Expiration Date (f).l.qs
Constr Contr. Number ~
7S.\Q .qs
Supervisor
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
~ $ 40.00 y~.,.p
$ 55.00
$ 80.00
volts see IIBI1 above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Signaturjtof Supervising Ele~ian
Vi/A/~ , a./~
! \Jwners ~e 11lrt:K
Address ') __~f?a{ 11 1 i1Ild
Ci ty a J(J~YlL Phone 41?:5.:lIef{ /
~ALLATION
Branch Circuits
D.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
.
not included)
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
Owners Signature:
:;2, 4" t::J _ p-
I~. --
7,2,0
-;l_ ~ _~. .;zc::s
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
"1-/<>. 9S"
/6 4J :z..9
./' L.."..:." _..- r..
~-
DATE:
RECEIPT 11:
RECEIVED BY: