HomeMy WebLinkAboutPermit Electrical 1996-12-18
Tt,~ t~l, 0 prolact as submitted haS leo' ow,~
t,,;-..I!:I uf'ld do~ no1 re'quJie specific land use
oPP,Qvul.. C
. .' V .
J ~.;nljrQJd Jo . . . .
D"t,,~fI' .... "
9A4i7,r],lzed \>lgn8l.;'. c...L. nil J j ;f.~
726-3769 ~.
225 FrITH srREET
SPRINGFIELD. OREGON
INSPECTION REQUEST: .
OFFICE: 726-3759
1. . .I:.OCATION OF INSTALLATION
.P7n CL"{MP/(. ~-.;'
'LEGAL DESCRIPTION
. 1r1 fl 'h '7A/7 'h I ;, 1-r0lJ
ELECTRICAL.PERMIT APPLICATION,
. Ci ty Job Number . ift.! I ftej. V ,
3. COMPLETE FEE. SCHEDULE BELOll
,.
A_ Ney Residential-Single or
Mul ti-Family per .'dvelling uni t.
Service Included, .
, . JOB DESCRIP:rION I, I ,. . . '"
~ ta:lIs~.Il~Alll ~lblJl w~MA/-I- .
Permits are non-transferable and expfre
'. if :york is' not started. yi thin 180 days
"
of issuance or if vork is suspended for
180 days. . .
2. CONTRACTOR INSTALLATION ONLY
'. Electrical Contrac.to.r ~A~
Address t.il1I ~.L fTf ~ .
Ci ty 13i-xq;- J;l:>
Expiration Date
Constr Contr. Number
Phone' 2~ff'3Yr.l/o%.o .
l'3e~~,_"
101, (CfQ
M,,~
qq'J
,.Supervisor License Number
1000 sq.ft. or.less
Each additional 500,
s~. ft or portion
thereo f .
Each Manuf'd Home. o~
Modular 'O\leliing
Service or Feeder
.B.
Services or Feeders
Installation,. Alte.rations
or Relocation', .
Items. Cost
Sum
200 amps or less
201 amps to 400'amps
. 401 amI's to. 600 amps
. 601 'amps to. 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 85.00
S 15.00
.: $ 40:00
$ 50..00.
S 60.00
S100.00
$130.00
$300.00
$ 40.00'
C.' Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
S;;~a.o~ SilZ11J;an
OWners Name~la::o;,~.
,
. Address ~I S~..s,~
Ci ty ~ . Phone {gflJ s:o.-olCD
OIlNER INstALLATION
.(9
The installation is being made on
property I ovn Yhich is. not intended
for sal~. lease or rent.
9vners .Signature:'
---------7./-----
DATE: I?A/~ ,1lt ,
BECEIl:'1'f:. ~,-
RECEIVED BY: .. 'U.IJII'{
,"'.... . ..
I':.',".> "__.
. .."..,~ '. -'."
".. .-. .'.
D',
200 amps"o-r less . .
201 amps. to 400 amps
Over 401 to .600 amps
Over 600 amps or 1000
Branch Circuits
$ .40.00
$ 55.00
. $ 80~00
vo.L ts ,see '!B" a~
-.
Ney, Alteration or Extensiori Per Panel
One Circuit
Each Addi tional
Circuit.oryith Service .
or Feeder Permit
$ 35-.00
$
2.00
not included)
Misce~laneous (Service/feeder
-Each installation'
Pump or irrigation
Sign/Outline Lighting I.
Limited Energy/Res
Limited Ener~J/Comm
5.
SUBTOTAL OF ABOVE
5% State. Surcharge
3% Administrative Fee
TOTAL
,. . --.... .-
.. . .
S 40.00
$ 40.00 'f:JJM(}
$ 20,00
$36.00 _,
'-/0.00 .
z..OV
-t..t,.-t; f ,'VO
$ '-13, ~1. ik1J.O
fi '1ho tollo\. project as G~bril.itted has.the following.
-. . l:oning, and does not require. specific land uoe
pet:... ""~~t, tL
. 225 ~IFTIi STREE'l' o.t.4/1-(P~'. . . "
SPRINGFIELD, OREGON l~il;47.ihd Signalure ' ''X---
. INSPEC'rION REQUEST: 726-3769 . -.
. OFFICE: 726-3759 '. ," .
. . 3. COllPLE'IE FEE. SCHEDULE BELOY
1. . .LOCATION OF INSTALLATION
1J7n CL~..d"" 5r~'
LEG4I. D;:SCRIPTION '.'
n 0 '1] 'Jd'J 'lJ 10 Tl Ct()
. JOB DE5CRIPTION . . .
~fib)c ~UlI~6S1~S"
permi.ts are non-transferable and expi're
'. if york is' no t started. vi thin 1:80 days
"
of issuance or if vork is suspended for
180 days. . .
2. CONTRACTOR INSTALLATION ONLY
: Elecuical Contrac.tor :JJJ.kF...~
Address t/LIII r;.k fTf ~
ci ty ~ 7;;t) Phone' t,rt-3'I!:"-1.//J'l.o .
'3B~I4I,.-
/01, /q",
ConsU Contr. Number "W(,~
-qq'1
"Supervisor License Number
Expiration O!lte
Expiration Date
S;:~a,:~ Sl1~IlW'
Owners Name~C.M'~'
.' .
. , Address 5&.01 .s1Jkl';"<:>t~
Ci ty ~Phone {gfl) $11-D/(1)
oVNER INstALLATION
The installation is being made on
property I ovn 'ilhich is. not intended
for sal!!, 'lease or ren t. '
Owners .Signature:'
8tf1 (v(j~l~':u - ,
RECEll'T!: . 1\ i f'7
~~IVED BY:'~J'i/
DATE:
._.n."......
-.. ...". .'.
....:..;
/'/~_.~~___--:.:-_..-::....,_____-'::~.'::""._n_. ...'
ELECTRICAL.PERMIT APPLICATION,
. Ci ty Job Number.. . Ci (p / r.n y .'
,.
..' A_ Nev Residential-Single or
Mul ti-Family per .'dvelling uni t.
Service Included: .
Items. Cost Sum
1000 sq. ft. or.less 5 85.00
Ea.:h additional 500,
sq. ft or portion
thereof S 15.00
Each Manuf'd Bo'me. or.
Modular. 'O\lelling .; : s 40:00
Service or Feeder ---
,B. Services or Feeders
Installation.. Alte.rations
or Relocation:
200 amps or less . S 50..00.
. 201 amps to 400'amps S 60.00'
401 amps to. 600 amps 5100.00
. 601 'amps to. 1000 amps 5130,00
Over 1000 amps/volts . 5300.00
Reconnect Only 5 40.00'
C. : Temporary Services or Feeders
Installation, Alteration or Relocation
C'.
200 amps"or less . .
201 amps. to 400 amps
Over 401 to .600 amps
Over 600 amps or 1000
Branch Circui t.s
5 40;00
S 55.00
. 5 80~00
vOJ. tS . see I~BIf above
'.
Nev, Alteration or Extensiori.Per Panel
One Circuit
Each Additiona1
Circuit.or.vith Service.
or Feeder Permit
5 35'.00
5
2.00
.{9
not included)
Misce~laneous (Service/feeder
-Each instal~ation'
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5 40.00
S 40.00
5 20.00
5.36.00
.~
5.
SUBTOTAL OF.ABOVE
5% State. Surcharge
3% Administrative Fee
TOTAL
1./0.00 ".'
z..OV
-t.-t,;{, -f. ~
.. tj3..:u,,-Lf-5; ~
...
',-: ..
lr. ",,,If..
" I
. k: ~ .:~:i:Wt Cre."p.ec:!/c land u~
/'\) CJ. ~ulel5:f J~~. " .'
225 FIFTH STREET uthonzed SlgnEitur~~LEcrBJ.CAL. PERHlT APPLICATION,
SPRINGFIELD, OREGON 97477.. '. ' . . . . . .
INSPECTION REQUEST:' 726-3769' ... _ . City Job Number. . qf.t !lP0(
OFFICE: 726-3759
1. 'I;OCATION OF INSTALLATION
~ ri c;t..~",f"(, :So___"
LEGAL DESCRIPTION . .
1-1 h 'h '//1')1, I ,,-11OD
1'.I..~~OB DESCRI~ION .
.lAIJ6WII.1~~ "~s,~"
Permi.es are non-transferable and el<:pi're
'. if :"ork is no t star ted "i thin 1:80 days
'.
of issuance or if "ork is suspended for
180 days. . .
2. CONTRACTOR INSTALLATION ONLY
'. Blec'eric-al Cont:-actor ~.~
Address WI! r;.JJu.", ~
/ -
Ci ty ~cr;.II> Phone' 2,f{-Jtlr.I{O'Z.O .
136 "::lU:l.".
,01, Iqq
Constr Contr. Number PbtI{,~
r;jq'7
?upervisor License Number
Expiration Date
3, COMPLETE FEE. SCHEDULE BELOY
,.
..' A.
Ne\l Residential-Single or
Multi-Family per ,'d"elling uni t.
service Included: '. .
Items. Cost
1000 sq.!t. or.less
Each additional 500,
sq. ft or poition
thereo f .
Each Manuf'd Home. or
Modular. 'Dyelling
Service or Feeder
.B.
Services or Feeders
Installation" Alte.rations
6r Relocatio~: .
Sum
$85.00
S 15.00
:$ 40:00
S 50..00
S 60.00'
5100.00
5130.00
.5300.00
S 40_00'
C. :Temporary Services or Feeders
Installation, Alteration or Relocatlon
Expiration Date
S;:~a _.~~ S71~Illan
Owers Name
.'
. Address ~l S~-s,~
City ~Phone(gpj~-Dlt:O
OIlNER INstALLATION
The installation is being made on
property I o\ln "hich is not intended
for sale. . lease or rent.'
9vnersSign~ture: .
DATE:
RECEIl'T!: .
RECEIVED BY:
I..... . . '.'
I,:.,",>:._..:......~.. .
?t:Fil Ii ~
II'tM /I 0:.,
. ('30&/
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
C'.
200 amps"o. less . :
201 amps. to 400 amps
Over 401 to .600 amps
Over 600 amps or 1000
Branch Circuits
S 40.00 . .
$ 55.00
. $ 80~00
V01tS.see ~B. above.
, ..
'.
Ne\l, Alteration or Extension Per Panel
One Circuit
Each Addi tionlll
Circuit .or.with Service
or Feeder- Permit
,0
S 35'.00
s
2.00
no t included)
Misce~laneous (Service/feeder
-Each installation'
Pump or irrigation
Slgn/Outline Lighting
Limited Energy/Res
Limi ted Energy/Comm .
5.
SUBTOTAL OF ABOVE
Sr. State, .Surcharge
3% Administrative Fee
TOTAL
...'_...,......
_c.._~.:.;.:.:.:'.~~-=-_
S 40.00
S 40.00
5 20.00
S 36~OO
.~
t./O.oo '.'
z..OV
. ....t;t.' 1..1..0.
~.h't:L .11'z,o
,.,
....