HomeMy WebLinkAboutPermit Electrical 1995-4-6
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. bmltled has thefollowi
'Tha,foIlOWiClngdoePr~:t ~~~ire specific land use
zoning, an ...... '
, approval.' !leJ"!' ELECTRICAL PERMIT APPLICATION
,97477, Zoning L...' , rv t::;.1\!\ ":1 L -
726-5J~94-(~ ,-9) " " Ci ty Job Number '-\. '- )\r\< ~
AuthorIzed Slgnatti~.--,rjJ M ~~~7;; 11m SCHEDULE BELOV
1. LOCATION OF INSTALLATION
?-c?,:{ /J cS'~d
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-375~
LEGAL DESCRIPTION
/7?/;/J: /~..f 2.-66'/
~;r:' c71 tJ 7/'
, JOB DESCRIPTION
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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.
Expiration Date
Constr Contr. Number
Expiration Date
The installation is being made on
property I own which is not intended'
for sale, lease or rent.
Owners Signature,:
---------------------------------------
DATE: '7~"~C;-
RECEIPT #:~JE?~
RECEIVED BY: //~~
//
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modul(irDwelling
Service or Feeder
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
Reconnec t Only -
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$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
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
,.
New, Alteration or Extension Per Panel
$ 35.00
$ '2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline LightingM.. $ 40,.00 4t).OO
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE .;:j.{). ()O
5% State Surcharge~.OO
3% Administrative Fee /; ;;21)
TOTAL -1-, { . :2 /')
D.
Branch Circuits
2. CONTRACTOR INSTALLATION ONLY. B.
Electrical Contractor IJlI1l'ii/5 ~ .~~~
Addressc:lJ.f '-h~},~ r;~. 0
Cit~,tf~ A Phone,-U2~/~7
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Supervisor License Number '"t'.~ ')
1/1/ OOJ-
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Signature ,of Supervising Electrician
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. Owners Name~\~fc\; ~,,~_~
AddressLHO (\J\~D
.ci ty <Eiiv 110= Phone
OVNER IATALLATION
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit