HomeMy WebLinkAboutPermit Electrical 1998-5-8
The following project as IUbmllted '- the following
zoning, and doee not requke epecllIc land uee
approval, \
225 FIITH STREET ~onl Ai ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Del Q ,
INSPECTION REQUEST: 726-3769 1\ Ci ty Job Number -/7/75'",5
OFFICE: 726-3759 AJ..; . ',..: SIgneture ~ \ lV\ . "
3. 'f:;OMPLETE FEE' SCHEDULE BELO\!
1. LOCATION OF INSTALLATION
9"6'11" 1f',.vt"Jc.....J.u.,L?I'J_ la!.p- A. New Residential-Single or
- ~ 0 - /13 ,~.LMulti-Family per dwelling
LEGAL DESCRIPTION I '8 d 3 ,. ()}Uif -Service Included:
ILJlV vaL-h"tflft ,)-l? W,'rP_ Items
~O~ :;S~PTI~~ -shr-LLifr;-'J-> ~~~~ ~dd i ~ io~~ll~~~
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
unit.
Sum
Cost
$ 85.00
$ 15.00
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
,$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
,B.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractorllza~ 5~ 9n,re
Address II) 7"1' lkft(':4/ /(, nv ;4/ ~ .
- ".
City E~,./" Phone 3''!-5'--307:7
;:
Supervisor License Number ~~t7~&,f
g-~ ;2. 1'- cyzr
IJtJ756fP1
ff;- 2/j'-i'f
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
ZOO amps or less
201 amps to 400 amps
401 amps to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Expiration Date
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
Constr Contr. Number
$ 40.00
$ 55.00
$ 80.00
see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u vo~ts
Expiration Date
Signature of Supervising Electrician
7%--~ ~ I~~-
Owners Name OdJ..rrP H&,rl-t?PL
Address / 72-5 ('./2rr/aC?rp~
,
CitY~n~/elL Phone 746-6/#7
O\INER INSTALLATION
Branch Circuits
D.
"
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Addi tional .
Circuit or with Service
or Feeder Permit
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting /1f 40.00
Limited Energy/Res ~ $ 20.00 ~
Limited Energy/Comm $ 36.00
The installation is being made on
property I own which is not intended'
for sale, lease or rent.
Owners Signature:
'Z.t')t>-D
/,DO
Ili::1/)
"2 I ~f.l
_tC
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
---------------V~-T~-----------------
DATE: ~ 1-r/5'7'?
RECEIPT 11: ' 'j ,~4;U
RECEIVED BY: _rP'7' - -
'r ",,.. \,.