HomeMy WebLinkAboutPermit Electrical 1999-9-29
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The following project as submitted has the following
zoning, and does not require specific land use
225 FIFTH STREET approval. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zoning LO Yl- . ...' . q q 1\ S ! --I
INSPECTION REQUEST: 76R-3769 q-~"1- ~q Ci ty Job Number, U ' '.
OFFICE: 726-3759 a e -_ ,; l
Authorized Signature ~ 1. rOMPT .F.'T'E FEE SCHEDULE BELO'il
1. LOCATION OF INSTALLATION
~:2- 3' If S'/ICee-)
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JOB PESCRIPTIO N\i O~ 30 13 00309'~' .
" sq. ft. or less
<)~CC-Lu?/~ !j/S'/~ , 'l'l/Loa ~~itional.500
( -4J, ~~~ or portIon
Permits are non-transferable and expire v"'~e~~~.
if work is not started within 180 days C04?~)!~~~Q ~~me, or
of issuance' or if work is suspended for ,qiVy ~~A~~~
180 days. 180he~ YAA~f?'dt8:tf:h. . $ 40.00
~YA IS~ '1SA 'I"f~
2. CONTRACTOR INSTALLATION ONLY , B. servi~er~~A~~ WO"<;>>k'
AP_ (' InstallatIon, A~~~t~
Electrical Contractor~/AH/ ~~~/'J-~or Relocation: 0,.<;>>'"
. . Address.' /(; 9'0 f-;.o/fJ #/f/?"'"' #eV / 200 amp.,s 'or less $ 50.00
. 201 am'p';s~)",~b 400 amps $ 60.00
Ci ty R7/~?: CP1~ Phone~I/~-?t26f- 40~""~~P~~;~Q/{c~.QO. amps $100.00
. , 60{? amp's .to -rooo amps $130.00
Supervisor License Number "i5( IT CJG s- ov~,f~'/19r?~~if~~~\j\q~ts" . $300.00
,.~ a 1\~7~Hi,i}ec-t?;o,n'~y:,,~~,. ';.O'O/"'i'M $ 40.00
Expiration Date /C/ ..- / - f ,7 170. ',91/, Iqtl' Vi"' "1 YI:) C'f(j
6\1" '9 '//0"" v fr:: ',..,C'>~ . 'i'i 5'" .1....,1,
C. Tempora.ry,qSenl'ices" '6b:- FeedEfrs.
Ins tallit~j,on9t !(lzt-~~'la:t::i();h 2tJl:~~1:oca tion
""" \./~, . I/!I ')().' ->F10' ",'I". '(,1". Ie.
. '(if"",o,. Fe." 'Xf. ;9 05) ,'I,:,
200 amps"oT';X?s'i,:;'j'l;~orIAf9'9.S~<S'Sf~4fJ. 00
201 amps to 40,Qx~~~F~ ~l&j",,\;'i(~l ~$D55. 00 '
Over 401 to 600"'ap1p~bJ'.JV-?'~s.,&.s'S lao.oo
Over 600 amps or r6~0-'\iQ.n~s ~~e "B" above
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Constr Contr. Number /tJCJ '1 ~ /
, Expiration Date ,tP /~CJ/:; a
'rt:Signature~E1ectrician. .
vr~ _ fi'~CJ-I'>{g7C1rt---n.
wners Name / .O'~~7:ttLlL&-r4
Address ,') 3v ,~( S't-Srr ~
Ci tyStr/IlCI.,..i.dJd ~ "Phone ?/..t~tJ)'J b
OWER. Ir@~~TION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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, DATg~--~t~zr-t~~---------------~
RECEIPT #: ' , "
RECEIVED BY: 'I . tlJll I A ~
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items
Cost
Sum
$ 85.00
$ 15.00
/
Branch Circuits
,.
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder-Permit,
$ 35.00
$ 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 ~iJ..J'"
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
7% State Sur9harge
3% Administrative Fee
TOTAL
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