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HomeMy WebLinkAboutPermit Electrical 1995-10-20 Tho 1"'lIowlng project as subr.1~()d has the 1",,,"'0 . , zonir;g, and does not roquiro &ptI<-lflc land use approval. . L"'rL---- Zomn~ V ELECTRICAL PERMIT APPLICATION 97477 D lel,Ol"2.0Iq> . 726-;3769 · I S fc Ci ty Job Number, "'75/6152 Authorized SIgnature 3. OMPLETE FEE SCHEDULE BELOV 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759' ' 1. LOCATION OF INSTALLATION _"2 ss ~N\+<S+- LEGAL DESCRIPTION /')~f-::Zc.; $// ~.::..--...- JqB DESCRIPTION r fi\{)vvVJ.J _ 'SRAVi?,Q- Permits ar~ 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 Contractor G 1_0 f3 C!.....--- AJ bd'~. Phon~<-7071 Supervisor License Number ?,;rI V S Expiration Date ID - 9 6 Address ~S5 E- City A. New Residential-Single or Multi-Family per dwelling Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular .Dwelling Service or Feeder .B. Services or Feeders Installation, Alterations or Relocation: Items uni t. Cost $ 85.00 $ 15.00 . $ 40.00 $ 50.00 S 60.00 $100.00 $130.00 $300.00 S 40.00 Sum 50 Constr Contr. Number 10 J (, 7 '7 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date I~ 'i' (, ~ C/ ;ft D. Owners Name ~~6' /k~ Address I 6 5 PILQ~':-"5+ Ci t;5f (\ (\~ pJd Phone ~ yt;/.- ..,-'7.70 OIINER WTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: --------------------------------------- DATE: RECEIPT 11: RECEIVED BY: 1/7 . 'Z t?-9';; /7.] ~ ~~ 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 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts S 40.00 S 55.00 S 80.00 see 1IB" above Branch Circui ts " New, Alteration or Extension Per Panel One Circuit _'If ~ ".00 Each Additional Circuit or with Servic~ / or Feeder Permit ~ $ 2.00 :z.S ~ not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00 $ 36.00 I:/Lg ~. DO- *rh/.. ' J ")> ~.-=!5 $~, ff,~ 51fi'. -=> --:;>-9- /.?9' ~?'T