HomeMy WebLinkAboutPermit Electrical 1997-5-5 (2)
.
Thf.' follcwinQ proiect as submitted h:l!l thoJ followini.
z,'.;'rlg, and ovc.s not rsquire spvcific lund u::'J
~pproval.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Zonina GD e....
974r}<fJl~OIl .)
72 RUl?61~&d Signature IV M
1. LOCATION OF INSTALLATION
_1()07 DIYI': n~ sprIJ,
LEGAL DESCRIPTIOP
/~~2. 1')5" z4 ~7~
JOB DESCRIPTION
A[n ~n{)Jtl d10i{)/ TICnJ
Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
ELECTRICAL PERMIT APPLICATION
City, Job Number
Cf702 J./h
3. COMPLETE FEE SCHEDULE BELOI/
A. New Residential-Single or
Multi-Family per dvelling unit.
Service ~ncluded:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
'2.0-360 Cr . [ n.t;,.,",\.. Installation, Alterations
Electrical Contractorlltr"'Q.r-,,:> t::.ec:t.I\Cl.II~or Relocation:
, ...... nVoc:.....
Address 7"L~(; ~ a.l Va.. f)c)~ Rcl. 200 amps or less
\ , ' \ . ....~. _ '201 amps to 400 amps
Ci tY.d!:\,b./-:T\<M P:h vPhone o'fl "1'i'f5 bT}'L 401 amps to 600 amps
~ 601 amps to 1000 amps
Supervisor License Number 37 I J, So Over 1000 amps/vol ts
Reconnect Only
Expiration Date 10- I 0 -'1~
Constr Contr. Numbel' e"r'lll>ce b
Expiration Date 3~2..'-I .cr'B
Signature of Supervising Electrician
~ c'f~,~ d!h,
Ovners Name ..-1e>~ ~V,~
JW ~.7.o~ oAt_
Add res ~ _ _, . .Or,-Q'l!:; Ix.
Ci ty ~JI'9t Phone .:;J:3.'~ - c.... ~
7f-7-/713
-, I -
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Ovners Signature:
~ATE~----~~~~-~-----~----------
RECEIPT 11: n ..L.:::J..OI \
RECEIVED BY: ^' WUA
Sum
$ 85.00
$ 15.00
$ 40.00
$ 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 volts
D.
Branch Circuits
$ 40.00
$55.00
$ 80.00
see liB" above
.'
Nev, Alteration or Extension Per Panel
One Circuit ~
Each Additional
Circuit or vith Service
or Feeder Permit ~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
'-
$ 35.00
~
;G
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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