HomeMy WebLinkAboutPermit Electrical 1996-12-4
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225 FIFTH STREET 1-0"'(\~n\. \ 1/ 11' ------- ELECTRICAL PERKIT APPH~IOIfN
SPRINGFIELD, OREGON 9747'1.>1" '("1;; ~ ____ q 41 I I
INSPECTION REQUEST: 726_37691-0(\1 - p,lV' ________City Job Number
OFFICE: 726-3759 ________ ~ uu__ "-
octo " SI<;'~O 3. COHPLirrE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION."oil1-""
j9Z() fJ/'fr't,PIC ~ A.
. ,)LEGAL DESCRIPTION 1/03 ~5 3/ o7'l.YJ
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Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY .B.
Electrical contractor~~~~~1
I .
Address /4). k 2..l"D ~ ,
Ci ty :J!F/)(;YJ&
Phone t;41-fpAlr2:J6S
Supervisor License Number ~~-~
Expiration Date /tJ -j- 7.F
Constr Contr. Number_~-/q5"L
Expiration Date It; -1- '77
S~~~~Electrician
~, . /
Owners Name ~e ~ 7.,df;.,
Address 5"590 ./iiJf~Y1~ .AY.iWUJr
Ci ty "${;IJIf Jt), Phone 2~,g -377-(j/O
01lNER INSTALLATION
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The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
----------------~---------------------
DATE: /-"2-'" Lj"'"IV
RECEIPT I: ()~ ~ ~ 1(J U . ~
RECEIVED BY: f...J. IY\a.cJ.....&-rJ'LJ
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
It ems
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular. 'Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less I~
201 amps to 400 amps --L--
401 amps to 600 amps
601 amps to' 1000 amps ,
Over 1000 amps/volts I
Reconnect Only
C.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
~,~
Ctn,l!!
/50.00
.!!.B::> .co
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
"
One Circuit $ 35.00
Each Additional
Circuit or with Service ...
J' -,.... ':"
or Feeder Permit ,t;&!:> $ 2.00 ~
$
$
$
$
2--~,ch "
~.oo
(,.~
:If 2...4~~,JW
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
40.00
40.00
20.00
36.00