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HomeMy WebLinkAboutPermit Electrical 1995-11-13 . . The folloY/log proj....:t [l" I L0ninn. and dOfjQ ~ot r~q~~bm.tbrJ hD'11ho foJlowl <1ppn:n.'nl. ...Iro r.p<X',:iI,J hin\:! un9 "l.;.l ELECTRICAL PERMIT APPLICATION 225 FIPTH STREET SPRINGFIELD, OREGON 97477 Locin" d LJi;? INSPECTION REQUEST: 726-f~U;9 l { _I 3 _ c~ c:- OFFICE: 726-3759 ---' ~ ,A~Jl("-r.-_'_'" ...... . ,... .....:-.. :;:.ognatura 1. LOCATION OF INSTALLATION J!:?// ~?'7' ~c..~~~C LEGAL DESCRIPTION 17~~'7?-Y2/~/~/3 , . ' / JOB DESCRIPTION r- '72 LLmL'&.d""',-~~ :~~ Permits are non-transferable a~~~~ if work is not started wi~hin 180 days of issuance or if work is suspended for 180 days. Af A. 2. CONTRACTOR INSTALLATION ONLY Elec t ri cal Con t rac tor ~""Y.N'~ E~_ r Address :z?J!i?"2 c;;:.~L .~'!.O_ Ci tYtLr;;..~~.AY~ Phone Yo/~-;:>:2-:J::> Supervisor License Number .:('''5"..:?'::::> 5- Expiration Date /6~/~ Constr Contr. Number 172""L Expiration Date g.."5'-9~ Signature of Supervising Electrician d:r/~~ ow~ N:me r.~:- ~T7- Address !f??/ yr ~c::. ~/=- City ""'5~c.O Phone~..,...y.:S'~ , OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: RECEIPT II: RECEIVED BY: /1'/3."~ / ~~&;; ~ .-..,.oJIl ., ~ City Job Number ~5"'"/?? 'I COMPLETE FEE SCHEDULE BELOV New Residential-Single or Multi-Family per dwelling unit. Seyvice Included: Sum Items Cos t 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular 'Dwelling Service or Feeder $ 40.00 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 $ 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 $ 40.00 $ 55.00 $ 80.00 see "B" above D. 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 -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 40.00 40.00 20.00 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ 36.00 '(I. de> 2'_ ~5' / ' "2'" 4'Y 2.8