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HomeMy WebLinkAboutPermit Electrical 1994-11-18 '. -',e . The following project es submlttod has tho follow! zoning, and docs not requiro spectflc land use 225 FIFTH STREET approval. ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 Zonina eM q) (I A-o 3 INSPECTION REQUEST: 726-3769 I~ L' City Job Number ~ /'7_ OFFICE: 726-3759 Data 11- D --,4-, Authorized Slgnat~n.t tJ M.- 1. LOCA:I'ION OF INST4L~TION '" 1,0 Lj I ~0fP A/'II\ \ 1.1 " 1)(" LEGAL DESCRIPTION I '7 0 ~:::>-'1{ l~ 0 3C, /f) JOB pESCRIPTION it dd ,?, (\ .'Nt u .f::k Permits are non-transferable and expire if IIork is not started 'wi thin 180 days of issuance or if,work is suspenaed for 180 days. 2.,- CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician . , Ollners Name Jtt,,, llVy\,tVl ~.DJLev Address In itl I2-Nf'./ltJ\L\ br City ~te-\ Phone) L) trip 113 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. . O&~/,/ // - ~ /~------------------ --------------- ?1lATE: II ~ IX" -'1_ 9J9 ' RECEIPT ff: 17,>5 RECEIVED BY: (JAA.A^~' COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling Service Included: uni t. 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 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100,00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 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 $ 80.00 see UBI! above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 7 $ 35.00 ~1J.CV $ 2.00 LJ.DD E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. $ 40.00 $ 40.00 S 20.00 S 36.00 '2{1.m {. '1? ),17 Ll7./ ~ SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL