HomeMy WebLinkAboutPermit Electrical 1996-3-14
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SPRINGFIELD
The following prc1sct D.S GUbm:t'3r1 h~..G thn fc
zoning, and doer> not require specific l.lnd Lise
approval.
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"" / tJ / - ELECTRICAL PERMIT APPLICATION
97477 Deta.6 &;7
726-37~9.horlzod Signature ~ City Job Number q 5 } '? 3 (p
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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
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Electrician
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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:
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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
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