HomeMy WebLinkAboutPermit Electrical 1998-2-26
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1iie followlng project 89 oubmll!Ild has the IoIIowtng
zoning, and does no! requlre apeciIic land use
lIpproval.
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225 FIITH STREET bme?/...u" 1';.{ , ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON ~ $lgn&ture...lL M
INSPECTION REQUEST: 726-3769 .:.;. ty Job Numb~r ~40~~
OFFICE: 726-3759
3. COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION
-5" ?"!? ~c.7"#~ ~ -
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
A.
LEGAL DESCRIPTION
/;>"",,]1-24/-2."3 O/I!?t:>/
"
, /. J~ DESCRIPTION
...Yf'//7f(~,;z:-~ "'7~~P'S
Sum
I.t ems Cos t
..
1000 sq.ft. or less -I- $ 85.00 &:::2. ~~
Each additional 500
sq. ft or portion
thereof '2 '$ 15.00 ~p_'-"'"
Each Manuf'd Home, or
Modular, 'Dwelling
Service or Feeder $ 40.00
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 ~O ,B. . Services or Feeders
~ Installation, Alterations
Electrical Contractor ~./~' . t'~. or Relocation:
...... - ...~' 'IT.'
,,~UrItOl"o '!I1/r s. 200 amps or less
-v4(4f.s '~t:D'u. ft-'lll2Jl.l amps to 400 amps
Phone -'lNv.. N~ ~D~~~/~~ps to, 600 amps
'aoO o~ ~ 'um~h~o 1000 amps
1'/ y ~.s /S ~(pv~~EplJf18pw-'s / vo 1 t s
~/OD ~8n~pr\'l'W.t
, ~~D lSNO
C. Temporaf~~er~ices or Feeders
Installatlon, Alteration or Relocation
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Address
I-
City
Supervisor License Number
Expiration Date
Constr Contr. Number
$ 40.00
$ 55.00
$ 80.00,
see nBIl above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Signature of Supervising Electrician
Branch Circuits
D.
Owners Name~~--:4 W#//6/
Address /1?16'-7 ~~~-
City p~~ Phone "3~~~?>
7 ,.
O\INER INSTAL~6':~
.'
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each AdditioDal
Circuit or with Service
or Feeder Permit
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE // ~~
5% State Surcharge 'C:;. /$"'
3% Administrative Fee ~. '/~
TOTAL -PC! .20
The ins talla t ion is being made on
property I own which is not intended
for sale, lease or rent.
Ovners ~ira~ure: ) ~ \)
~ fAA... {.)J.J\
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, RECEIPT 11: \J.......,.. n 1\ A n .L /!
RECEIVED BY: \,\\1...:0. _' tJ-..~