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
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JqB DESCRIPTION
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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
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