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HomeMy WebLinkAboutPermit Electrical 1995-5-31 ,., " 225 FIFTH STREET ELECTRICAL PERMIT APPUCATION SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 City Job Number <9~~"5' OFFICE: 726-3759 1. LOCATION OF INSTALLATION '- /2p!C tI/ ~er-.,~c. .-'f' LEGAL DESCRIFTION /?~"3 -2':>- "'3/ ~/V~ r , JOB DESCRI~ION ~~J/:.w- ~AI!>r# 4~ 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 INSTALLA~N ~y Electrical contract~,~ Address sif/..1..... tvJ~ City Fr; - -U>C71. ' Phone_6<C~~~)l:>1' Supervisor License Number ~ 7~-~ Expira t ion Da te / {)-/- p'5 Cons t r Con t r. Numbe r d-o -/ 9 -C- Expiration Date /0-/-7'.:5 SiI'~ ~:U Electrician Owners Name ' /~E ~:~ y - . - . c Address ~ C~./':.,,?( ~ - - Ci ty -'7;-,/-LZ) Phone 7.l/~~~e:>y OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent, Owners Signature: ~ DATE~---------~~-~~~-~----------- ""''''''.1.'1 I: /~? RECEIVED BY: /' ,/ _.-? - ,_ . ?~- :': . i . .., .:. '_~.~:......' '., .", ." ..' 3. COMPLETE FEE SCHEDULE BELOIl A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 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 $ 85.00 $ 15.00 $ 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 Onry --- $ 50.00 .2i:Z:.~p $ 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 100U volts '" $ 40.00 $ 55.00 $ 80.00 see "Bn above D. Branch Circuits " New, Alteration or Extension Per Panel E. One Circuit .$ 35.00 Each Additional Circuit or wfth Service or Feeder Permi t ---'L $ 2.00 :::;?;?. c-t> Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lightinp- $ 40.00 ,I Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 SUBTOTAL OF ABOVE 7:::? --7""~ "'-,- ~.o 5% State Surcharge ,. CP_ .:r_ - t... 3% Administrative Fee ~- {.,.ao .'9~ TOTAL --" "7"- ~ ~C--~.f'7~.p""- 1~.~ :; ,,:.".'... . '",!;,,;,.' , . !:?i?e>-/T 5. ",' .