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HomeMy WebLinkAboutPermit Electrical 1995-5-15 71'e5 . . . . . The fOllow' . Zoning Q 109 project as 225 FIFTH STREET .pprov~/. nd does nor req~~~mlttod has the! IIE~CTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 · sPecfflc land u~.owmg INSPECTION REQUEST: 726-37w>ning L O,?? City Job Number 9?~2~ OFFICE: 726-3759 D.'e & I)"--;:f ,- ,-- '22 3. - COMPLETE FEE SCHEDULE BELOV 1. LOCATI9N OF :r;NSTAI1J\'h:ew Signature kh... 1c5o ~~~\ L~ -!.~"\. A. LEGAL DESCRIPTION /7~~-~Y-T~. c7t/~ JOB DESCRIPTION ~-\:br\ld';AM) :1n{)ClIrm~n.lw,o , 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. CONTRAcrOR INSTALLATION ONLY B. Electrical contractor~ 8bQ~"t~11I \\1iM..., Address p.O.~. 14~1-J Cit~~~,~.rL Phone '14/-1.1,3fn Supervisor License Number II, Sih,~ Expiration Date 10-1-<15 Constr Contr. Number O~'2t./,~ N~w 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 $ 40.00 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Circuits 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 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 50,00 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date q-I-Q!,) Signature of Supervising Electrician _~-dL-o~ o:;:rs'Name~~rl" t'D~, Address b50 Ru:rt~'l ~ ~ (\ ) ~ l\..> . Ci tY,4J\1 m~t/" ~ nlLPhone.11...4- - () ."ltJ.1l OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: RECEIPT It: RECEIVED BY: "f\ /9",,"- /~?.J,( r' -/,>~ __ i $ 40.00 $ 55.00 $ 80.00 volts see "B" above .' Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 35.00 $ 2. 00 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00 $ 36,00 So , 0.0 ~,5o l. 5',., 4.a.o