HomeMy WebLinkAboutPermit Electrical 1995-6-28 (2)
r"., fo!lowing project .. oubmltted has the following
,. . : ." and does not require epeel!lc land uee
t:p!':',i"al.
Zoning 1___ D l2--
225 FIFTH STREET (;~.'1 It,- L (>11..(
SPRINGFIELD, OREGON 97471 N
INSPECfION REQUEST: ~2~~~~gnalure jV\..
OFFICE: 726-3759
1. LOCATION OF IN. STALLATION A
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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ELECTRICAL PERMIT APPLICATION
:: ty Job Number q c::;--/ CJ 77'
3.
COMPLETE FEE SCHEDULE BELOV
~ .
A. 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 $ 15.00
Each Manuf'd Home. or
Modular .Dwelling
Service or Feeder $ 40.00
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. CONTRACfOR INSTALLATION ONLY
Electrical ContPactor"~ J\JO~.~~
Address / /J /2 ,<)/~AL~ LJ) .
- I .
Ci ty_ j:;T./c; . Phone ~ - 72. J /
super~'fl"L'i~ns~~ ds.'? L~
,
Expiration Date /r,/9.J
Constr Contr.Number o/91-tJ39
?/2. ~~>'r:-
\~suP~it~1~~2d;-
"owners -;:me ~~~. CL/d
Address U 362... Ll/'p'/' A-- Sr;
Ci ty J ~ ~ . ,..,.,. ~ne f 'Yo )1'7 ?..,c!id
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OVNER INSTALLATION
Expiration Date
B.
Services or Feeders
Installation, Alterations
or Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see nB" above
New, Alteration or Extension Per Panel
."
One Circuit ~ $ 35.00 ~
Each Additional
Circuit or with Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~-:~----~~;C~~.~~_~~~-;-------
RECEIVED BY: ~...""
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