HomeMy WebLinkAboutPermit Electrical 1997-8-11
T'.,.... '(',"')v':'1C ..,~....:....,.t b'
"'\ .' . as GU miffed has the follo\"in
7, (1/1\.1, ...rld tlQ;:- I':' roquiro specific land u . g
...ppro'./Hl. so
225 FIFTH STREET .li " ELECTRICAL PERMIT 'APPLICATION
SPRINGFIELD, OREGON 97477 Zoninp--1!..~ DJ /
INSPEcrION REQUEST: 726-3'l69t{-J/.ry CitYJ~b Number -( 0 Lf / /
OFFICE: 726-3759 f/
' Authorlzttd Slgnatur. !JI1 CQl1fLETE FEE SCHEDULE BELO\I
A. Nev Residential-Single or
Multi-F~mily per dvelling
Ser~e&-\lncluded :
~~Y-~ ~O~ Items
~~~ ~ _,,&~ ,'0
. \.~i-~ ~'(OOO ~~\'-ft. or less
_:\\Cf(;. ~c..Y-~'V 1?-~''O ~~additional 500
~ ~~~\\ \\~~~ ~~~~~q. ft or portion
Permits are non-transfera ~rrd ~tltPrre..,'O~ thereof
if vork is not started vit ~~~~~~~~ ~O~. Each Manuf'd Home or
of issuance or if vork is s~~p~~~~~~~ Modular Dvelling
180 days. c,o ~"" O~ Service or Feeder
~'{ ...
2. CONTRAcrOR INSTALLATION O~Y B. Services or Feeders
~ \..l f\ ,rt--;:"c:..Installation, Alterations
Electrical Contractor f\ I lJ\( J:'\ ",D0\..i or Relocation:
Addres's~ 0 f'f\ \ \\1Dd" 200 amps or less I
C, flAt)... 111 n-, 201 amps to 400 amps ~
Ci ty U "G.Q1\O~ Phone I TI..J.:.1..id:lJ 401 amps to 600 amps
~ "~f)f'\Q 601 amps to 1000 amps /
Supervisor License Number N" \::ilJ.;:) . Over 1000 amps/volts
\1'\. \ . (\, (1" . Reconnec t Only
Expiration Date \ , '"
- .
Constr Contr. Number \~~~
).. .<t -lY6
1. LOCATION OF INSTAL!,t\T.ION
~'5l(JL( OhlWtfi1/ ~~
I
/-)OGJ38fm.Yi4'l-/
JOB DESCRIPTION
Expiration Date
Signature of Supervising Electrician
~/~-4-7~~
~~ame ~bt;)ff- (X6~ -
Address1/{H7 en1d1 I / aw /
Ci ty j '. Phone '1'17-({; 7 tJ ((
m
The installation is being made on
property I ovn vhich is not intended
for sale, lease or ren t. ~ -1
Ovners Signa ture: d q( ) ,I}'" f
"I? /) &0';' .
~~~~~--------~~\\~C5Cf}--------~-----
RECEIPT R: . { ~ ".l\ \\~ ~
RECEIVED BY: 'd'~-~-' \, \V....;'/
C.
uni t.
Cost Sum
$ 85.00
'$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
:S&'<PO
;z.~d. t90
/3<P.oD
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 1000
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
$ 35.00
$ 40.00
$ 55.00
$ 80.00
vol ts see "BIl above
One Circuit
Each Addi tional
Circuit or vith Service
or Feeder Permit ~
.'
$
/'fr'&.oo
2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
S 40.00
$ 40.00
$ 20.00
S 36,00
f f5btP,tpo
?-r.d't7
./ ~ . rc'"
~V9, J-O