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HomeMy WebLinkAboutPermit Electrical 1996-3-14 '. . SPRINGFIELD The following prc1sct D.S GUbm:t'3r1 h~..G thn fc zoning, and doer> not require specific l.lnd Lise approval. ;;J40ni - nif) ru "" / tJ / - ELECTRICAL PERMIT APPLICATION 97477 Deta.6 &;7 726-37~9.horlzod Signature ~ City Job Number q 5 } '? 3 (p , ' 3. COMPLETE FEE SCHEDULE DELOV 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. LOCATION OF INSTALLATION CJ'do Rl.jJ~r ,(Na/! rAJo.r ,LEGAL DESCRIPTION II 0"3 .::l. 1. 000 1 t5b3 J9lI )lESCRIPTI,.QN '-~ ~ 'f'{> I"~ rJ f.J"e,w I'~ Permi ts al'e non-transferable and expire if york is not starte~ vi thin' 180 days of, issuance or'if york is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY ,D. Electrical Contractor B lto...d~~ llr'(,' Address 92.::J. 0 L I "If f. Ci ty ~A ,.I' 0 A ~ 'b-- Phone ;r'14 ~.2'i' 7 , cJ' Superv~sor License Number Expiration Date Constr Contr. Number ('p 7 ~ ( S Expiration Date if; .:tft ? . , A. Nev Residential-Single or Hulti-Family per dwelling unit. Service Included: Sum Items Cost 1000 sq.ft.. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home, or Modular 'Dwelling 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 Reconnect Only $ 85.00 $ 15.00 $ 40.00 S 50.00 " $ 60.00 $100.00 $130.00 $300.00 S 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"oT less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Ove l' 600 amps 0 r 1000 volts see "811 above , D. Branch Circuits . Electrician ~i1ie 0 c -1;, d n ' r A? " /,/ Owners Name f t"J L.. v ""- V / ~ Address c;q.), 0 L { U 12 City F., r--" Phone_4~'-31....:J.k OVNER INSTALLATION , The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: -----~-------------------------------- DATEu -/L..j - q(.. , RECEIPT lI: n::r..u (" '1lt' RECEIVED BY: J...J.. fYt~ Qd,O New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 35.00 " $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation . " Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res / S 20.00 tp.Ov Limited Energy/Comm $ 36.00' S. SUBTOTAL OF ABOVE 57. State Surcharge 37. Administrative Fee TOTAL rl-rJ ,() D i ." 0 .IDD ~ I. {pO