HomeMy WebLinkAboutPermit Electrical 7-8-22
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. ,LOCATION OF ~NSTALLAT~O~
qr//?lS ,~..J..-~W ~/~ S7: A.
'c:7
\~O~Wm>>r //7
~-~ri\ D\\Wi9t (Q~' ,,'
per~ar~ non-transfera~lean expire
if vork is not started vithin 1 0 days
.. of issuance or if work is suspended rr
180 days. ~O~ ~
2. CONTRACTOR INSTALLATION ~~~ ~ ~ ~O ,B.
~<<: ~~<<-~:.. <<9~~
Electrical contractor~~~
Address PD. ,{b"i,... e..~~;~: ~,>\j ;
. ~(ji'~ ~,,- ~W~ ~ '
City go. u.~~ r{>('<<-~A~~~O~~~ ...l)8E-J48~q
,~~v~~'
Supervisor L~~~ t~~~<i)2:l ;<,~-;~
~~~~~
Expiration Date r}5 J.~I -Q8'
~' C.
Constr Contr. Number_OSOSQ3
Expiration Date
,~-I&,-qq
Signature of Supervising Electrician
,~ hB~--
Owners Name.-:L O(ks~f.K' ,tloMhS.. ~
Address I eq S.. r6.c.ih'c.. I-h,.o3 / PI), 'i2Jm LlSl
Ci ty YVlonVYlnlJi-h Phone 5t6-~~%-OOCjfo
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
------------------------fr , ~ - - ---
DATE: /l ~ ,rr IlJJ G\ \
RECEIPT #: ~\ \t'A:J~ ~ . ~ _ - \
RECEIVED BY: V - ~ \~
ELECTRICAL PERMIT APPLICATION
City Job Number C\'\ \\~\
3. COMPLEtE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof S 15.00
Each Manuf'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
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' "OT less , /
201 amps to 400 amps
Over 401 to 600 amps
, Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see,tlB" above
D.
Branch Circuits
,.
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or vith Service
or Feeder Permit
S 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
- Pump or irrigation'
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$ 40.00
$ 40.00
$ 20.00
S 36.00
~c:;.o'
..;,L CA./
/ ,?-V
c.,/ --;>~ .:2.0
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL