HomeMy WebLinkAboutPermit Electrical 1993-7-22
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SPRINGFIELD
The following project sa 8ubmlltedh8ll the 101
zoning. and doe. not require specific land u
225 FIFTH STREET approval. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 .-w.:r:
INSPECl'ION REQUEST: 726-3769 Zon,na Ci ty Job Number q 3/ CJ~'2-
OFFICE: 726-3759' 0"0 /-2.-1.-- 1(,:>
1. LOCATION OF INSTALLATIOti"Ui"o"Zad Signature
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.' 1'71':f2 7=it::> ~O 1e'f:2A-
LEGAL DI!SCR1:PTION'" ., .
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JOB DE~PTIO~.. ~
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Permits are non-transferable and expire
if work is not started within 180 days
'of issuance or if work is suspended for
180 days.
i
OVNBR INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
DATE:
RE"r..u., I: '
\ RECEIVED BY:
~;/~~1I~3-------------
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~PLETE FEE S~BEDULE BELOV
A. New Residential-Single or
Hulti-Family per dwelling unit.
Service Included:
Items Cos t
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof. $ 15.00
Each Hanuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
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
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting-----
Limited Energy/Res
Limited Energy/Comm
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
2. CONTRACl'OR INSTALLATION ONLY B.
Electrical contracto~~~~~
AddressJO Cf ..s EJ A.\ J...\- A..~_
City -q 0 A\..-. '"':1_ Y'I"\ Phone , 9 Clt - ~~~ \
Superv~sor Licen;;e Number) 4: i? 7J > .
Expiration Date J () - ! - 9 ~.
Constr Contr. NumberL:_~~~/'/
Expiration Date _' : ~ ~.2o/~L
. Signat~~. upervis;:~
4.-,4- ~
~ - . I./. ...,. - - - '- D. Branch Circui ts
Owners Name if VJ <::
eo I ^, D New, Alteration or Extension Per Panel
AddressJI,-,:;] 0 - L- "" Y1'I 'P I b l'P",-
C'I ~ oJ One Circuit ($ 35.00 35" ~
City S '0 .->s- ~ Phone Each Additional
Circuit or with Service
or Feeder Permit 1
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
$
/ ..~
2.00 J:2.....C
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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