HomeMy WebLinkAboutPermit Electrical 1995-8-7
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9747~~:ot:::l~L
72~Jl3'169;jS;iJnntu;& NM
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INST~LATION ~_
~BO ~~~'Ul2.... A.
L-~GA~SCRIIP81-Cl(g /';}.. 021d1) .
JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started vi thin ISO days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
.4l.h"LJ .:Gibd.t::"o
. .
3~ .:>//
Address /.2 ...,. vU
Ci ty ~#DRA<;
Supervisor License
Phone-1;J "7. \- - 21... 3 '1
Number /c!) <::!:>,.-:::::~
Expiration Date /6 -/ '- 7,S-
Constr Contr. Number tb$ :?~0
Expi ra t ion Da te '7 ~ '-I -9 \-
Signature of Supervising Electrician
t?~~ ~~~v~~
Ovners Name
Addr'ess
D.
JI~~.A..v Fd I~C'"
'r'7 "1 s, '5 ::r=:rt1 ~ I
,
Ci ty -<:0 ;:::..i?)
/ -
Ph9ne
'7./-JU -,49~
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
~~~E~-------~~-:~~-~--------------
RECEIPT #:~.- lo;!:,J~) \~
RECEIVED BY: iJ-vJ
"
ELECTRICAL PERMIT APPLICATION
City Job Number
tl.C;lJ-](.ttJ
3. COMPLETE fEE SCHEDULE BELOII
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
uni t.
Cost Sum
$ 85.00. a5--
$ 15.00 30
$ 40.00
Items
1000 sq.ft. or less ~
Each additional 500
sq. ft or portion ~
thereof ".
Each Manuf'd Home. or
Modular.Dvelling
Service or Feeder
.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
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps. 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "Btt above
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith 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)
5.
$
$
$
$
\ \~po
'd.~
}cQ~.V }
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL