HomeMy WebLinkAboutPermit Electrical 1997-3-7
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SPRINGFIELD
The foll.,wing project as submit'.Jd r:>. . .
zoning, and does not roquire vpcciiic L \'..: l'....
approval. t7
Pn;ng ]),e---
-L- . ELECTRICAL PERKIT APPLICATION
97477 Data r '
726-:R~rlz8d Slgnnture~JA~Ci ty Job Number Cj> U / && 1
3. COMPLETE FEE SCHEDULE BELOII
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
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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 INSTALLATION ONLY
Electrical Contractor J,-ro...~s: lit. f,'
Address
9L( ;:;,
OL-IVB.
Phone ]>L{lfJ-'j :2'17
. CC-
Cl ty. U jD ....,..JL
Supervisor License
Number
Expiration Date
"-=-~-
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Cons t r Con t r. Number, (0 7 (/1 S:-
Expiration Date
7-/..2 -97
Si~zIsing Electrician
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
,B. 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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see fiB" above
D. Branch Circuits
..
Owners Name Fufu.v-e-' 'C" (/<VA?/l
ff,' ~ 3 R/V"<. II a I '"Je
Address
City c:!: Lo."'~ Phone~<;-..5(7"
)
O\INER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
D~~E~------~~~~~-:;----------
RECEIPT 1I: ' :T ~ ~
RECEIVED BY: ~ - t~1. bt.---
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
40.00
40.00
20.00
36.00
..,{
$
$
$
$
;;20.00
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