HomeMy WebLinkAboutPermit Electrical 1997-12-8 (2)
.
. .
SpttCFIELD
· -Pi
approval. ..-. ''''''I'.wc C[!L:.';".~ l..:n.:: u..,J- ..."oJ
. Zoning ld.v-
Date/lb.?; 'Q-
AuthoriZed Signatur. .n '^ ^
225 FIFTH STREET 8-1-11 v ,
SPRINGFIELD, OREGON 97477
INSPEcrION REQUEST: 726-3769
OFFICE: 726-3759
~
1. lpCATION ~INSTALIII,!,ION )
4f')\'?--, '~--n(S~~tV'\J D
. \)
\~~~rIOf'A7 CD
JJz~j~~~"(\<L-- \ \rfjo
~e~~s are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRAcrOR INSTALLATION ONLY
Electrical contracto--:B:I('s 2:1,,;;-:
Address] r 7 ()
/I~
W(5T
City
Phone
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovner~Signature:
-,
DATE:
RECEIPT If:
RECEIVED BY:
-\a..'~'l.f J .,,/
vi, ,~()
fJ''i J" L/
ELEcrRICAL PERMIT APPLICA:5fON
Ci ~y Job NUIIlber ~l'\ \0'6 \
3. COMPLETE FEE SCHEDULE BELOV
. A. New Residential-Single or
Mul ti-Family per dwelling uni t..
Service Included:
Miscellaneous (Serviceifeeder not included)
-Each installation .
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited. Energy/Comm $ 36.00
\\~~
"7..1~
=.1;14. dzL
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular. 'Dwelling'
Service or Feeder
I
2-
200 amps or less $ 50.00
~ 201 amps to 400 amps $ 60.00
~ OJ} 401 amps to. 600 amps $100.00
a OF"! S 'Sl-<5' 'Cpo01 amps to 1000 amps $130.00
Supervisor License Number IdL/ _~V~~ ~~~ ~ver 1000 amps/volts $300.00
Q a. _ "'0,,- V~ ~~econnect Only $ 40.00
Expiration Date~1 0 - -c/ ~$ ~$ <5'1:
A I ,r..._ *C'J5-<'aefll'pfrary Services or Feeders .
Constr Contr. Number .;2. 1'1 .') ~(), <:>0 -t'~t~tion, Alteration or Relocation
oa r,o. ~I.i :S>~.~..t"
Expiration Date (j-;}- f"- ( ( i'~Q~lJ9A~..t;Ot~less
~0~~:9J.?' 0 amps
Ef:Ut~re of Super ising Electrician Over ."~ )~mps
Over 6 ~m~or.if1000 vol ts
0-9 OJ.
~ D. Branch Circuits
Owners Name _ {. . __
Df) \\y\ New, Alteration or Extension Per Panel
Address N6' 1
Ci tyJ1SJ J rt~ Phone -141~or
~STALLATION
.B. Services or Feeders
Installation, Alterations
or Relocation:
One Circuit
Each Additional
Circuit or with Service
or' Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
Cost Sum
$ 85.00 ~
$ 15.00 3(j
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see "B" above
,.
$ 35.00
$ 2.00