HomeMy WebLinkAboutPermit Electrical 5-2-17
The following project as submitted h~s the
zoning, and does not require specific land
approval.
225 FIFI'H STREET j () ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonina L-'V f2-
INSPECTION REQUEST: 726-37690ate 2-j-,-Q-(' City Job Number q(~t9177
OFFICE: 726-3759 . . f~ w
Authorized SignaturtR _ 'I\fo.JlMPLETF. FF.E SCHEDULE BELOY
1. LOCATION OF INRTALUTIOR n
jy:25 t.LAvCtv VI ~~/lIJ~, Ka . A_ New Residen tial..,.Single or
.c-vF/f5:8C. q?L/)"o Multi-Family per dwelling unit.
~ I LEGAIl DESbuPTION / Servi ce Included:
J 7t::; ~ Z-< 2...2.- ~7'e>2.- Items Cost Sum
JOB DESCRIPTION
~~;:.
/
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2 _ CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name ~-U '<2. v-+ ~ uJcty j/ ...tl f/'\
Address I~~"- ~V~ BiH:l~ <'2-d.
Ci ty c;..fF/ f) Phone 21 I ~ L" ') ;j
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
~ature:
.. -. ~- ' ,
~- -----~----------------------------
2./(7 AS'
I /& :Sf 3 4.-.
.q(~
DATE:
RECEIPT #:
RECEIVED BY:
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
B. 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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
D. Branch Circuits
,-
New, Alteration or Extension Per Panel
One Circuit ~ $ 35.00 ?~~
Each Additional
Circuit or with Service
.or Feeder Permit 1$ '2. 00 Z~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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