HomeMy WebLinkAboutPermit Electrical 1995-12-22 (2)
225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769 Ci ty Job Number 4~c::><-
OFFICE: 726-3759
1. Lftlr.ON OF );NSTI}LLATION
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J~ DESCRIPTION c-
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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, CONTRACTOR INSTALLATION ONLY ,B.
Electrical contractor----.klA:A- A/t,'rYhG
Address -;, 1. flu w-A-r ,
Ci ty e. ut,j/l ( Phone_f'o tj{ - jd!fJ
/
Supervisor License Number 1l./-;)0 ? (' l.t:
) b/;/CJk
Constr Conn, Number q ] JqB.
/ J/CJL
Expiration Date
Expiration Date
S~~~~:ing Electrician
Owners Name~[) ~ rlllrrla.fj' rD
Address_'? /1./ (:;c/tl' lk<lyLJif/
Ci ty fry Y//I, h"iJphone 1Lf /... llS.ru
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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OATE, -J ~q <:
RECEIPT 11:, - / /~ ~-
RECEIVED BY: ~~--...,...:2-.
.....
3. COMP~TE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cos t
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
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
$ 50,00
S 60,00
S100.00
$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
$ 40.00
$ 55,00
S 80.00
see "B" above
D.
Branch Circuits
"
New, Alteration or Extension Per Panel
One Circuit
Each Add i ti onal
Circuit or with Service
or Feeder Permit
$ 35,00
$ 2,00
E,
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
SignlOutline Lightin~
Limited Energy/Res
Limited Energy/Comm
not included)
5,
$
$
$
, $ 36,00
1[.1~;
_ 9, $'~
~D
40,00
40,00
20,00
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL