HomeMy WebLinkAboutPermit Electrical 1996-5-7
.
Ttle fO\!OWInQ p,\o.l)';;lI\.o,....'-' ..........."..-- I d
zOIl'r,g. and dooo nol rcqulro cpcclflc on UllO
approval. . .
225 FIFTH STREET ZOning ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 . !'f"p/l--'5/1, 1 /J c/ 5 L/ ~
INSPECTION REQUEST: 726-39'6s '/ / ~ City Job Number '17 771
OFFICE: 726-3759 Authcrlzod $lgnalur. . -
3. HPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
.;;J~~" ~{ifnpJ"c-
~G1Uo DESCRIPTION
J' f O"):} ho<-ll {ll I'>h?
JOB DESCRIPTION
/17..:;ial/ 5eru ~I
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days,
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
uni to
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
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Soo it '0 I Secu, i ty or Relocation:
\
Address P.O. Box 21009
Ci ty Euuene
Phone 461-5678
Supervisor License Number I~f("e.e:,. /
Expiration Date /0 If /?t:.
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
Constr Contr. Number 65149
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiratiqn Date 6-28-96
. .
Si~~tuie of Supervising Electrician
~<'/\.~,
~ - ~ D.
Owners Name Ore:J'Yl lY7&m (].~.d~J()Y) .
Address g0~ /-j("-tiJL/ /Jr,
City &gvn,p, Phone~~fS-71'-/CL
OWER INSTALLATION
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
.$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limi ted Ener'gy/Comm / $ 36.00 ~t,..o
/'/The installation is being made on
property I own which is not intended
for sale, lease or rent.
OYners Signature:
DATE~--~~~~-~-~---------------------
RECEIPT #: 7tlf/'i{ ,
RECEIVED BY: tb
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
::? IP =
i 'jfO
jOI:r
.~R88'