HomeMy WebLinkAboutPermit Electrical 1994-10-12
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The fcllowlng project ea submllled hM the
zor:ing, and dC03 not require Zpt...,:;ilic land w$e ..
approval. ELECTRICAL PERMIT APPLICATION
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759 OMa
Zoning
3.
1. LOCATION OF INSTALLATION Autho~lzod Sljlnature
7:J. / }(WlMt- elM- , "Jjl/iuWjP A.
LEGAL DESCRIPTION (J.
/70-~~" '5&/-'2:Z ~ c::::>4J "7..-'l
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JOB DESCRIPTION
ALARM SYSTEM
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. CONTRACTOR INSTALLATION ONLY
Electrical ContractorADT SECURITY
Address703 NE Hancock ~
City Job NWDber~/'5'/-=?
COMPLETE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
"
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
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
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Phone 284-3265 ext 35
City PDX 97212
Supervisor License Number 893
Expiration Date 10-1-96
Constr Contr. Number 59944
Expiration Date 4-1-95
pe~tri~ian
o s Name-ft-l/l;/- -; gLrk~~
Address 1~1 RfWJ~
City+~fU Phone 7tf(-7~?3
OYNERof~TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
--------------------
DATE: t~-~" "7 Y
RECEIPT : /~2
RECEIVED BY:? fJ
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
D.
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see nBn above
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New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
'$ 40.00
$ 40.00
$ 20.00
$ 36.00
20.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
20.00
/.00
.IDO
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