HomeMy WebLinkAboutPermit Electrical 1995-5-16 (2)
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SPRINGFIELD
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The following project as submitted. has e 01 o. I~
zoning, and does not require specIfic land use
approval.
225 FIFTH STREET Zonin~ L-- Dv
SPRINGFIELD, OREGON 97477 <;-H..f~.(
INSPECTION REQUESTpat9nC-J7d~ ..I -,
OFFICE: 726-3759 Authorized Signature IV 1\1\
1. L~~I9lL OF ~NSTALLATION
5: X)~ \ ,C\\ 5:\~~,
\~~~~~ION n\~20
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.\ ~OB DESCRIP1~ON _ J.-.r.. n '\.; (\ ,
V,-~(\(')<r\'"t") ~ \)\ 9)
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Permits are non-transferable and expire
if work is not started within 180 days
of issuarice or if ~ork is suspended for' -
180 days.
2.
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CONTRACTOR INSTALLATION ONLY
Electrical Contract
Expiration Date
Constr Contr. Number
Expiration Date \~
Signature'of Supervising Electrician
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Owners Jame ~ \\h'C\ ~O, _
Address~\f)~ ~\j(
Ci ty ~\\~ ~ Phone C\ \~~ \.vl~
O~\~AL~TION -
The installation is being made;dn
property I own which is not "irt;1tended
for sale, lease or rent.
OvnersSignature:
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DATE: f'VIU -Crt? r, '
RECEIPT #: 01 r ('t01 '~ .-
RECEIVED BY: 'I U/f
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A.
B.
C.
D.
E. '
5.
ELECTRICAL PERMIT APPLICATION
City Job Number
3. COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling
~~rvice Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each ,Manuf'd Home or
Mod~lat,'Dwelling'
Service or Feeder
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 \
C/horobD
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Cost
Sum
$ 85.00.
$ 15.00
.
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00 L\\-- ~ cO
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
Branch Circuits
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New, Alteration or Extension Per Panel
Mi~cellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit'
Each Additional
Circuit or with Service
or Feeder Permit
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$
$
$
$ 36.00
A.a CO
~'PO
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40.00
40.00
20.00