HomeMy WebLinkAboutPermit Electrical 1999-2-18
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ELECTRICAL PERMIT APPLICATION
Ci ty Job Number 9' '/6.:1()
B~ tfJ I
New Residential-Single or ,O~ I:/J /
Multi-Family per dwelling unit.
Service Included:
The. following project as submitted hes tho following
zonmg, and does not require spoo,riic land Un.:;)
epproval.
Zoning' W- V
225 FIFTH STREET Dat~
SPRINGFIELD, OREG~..?~2F-SlMolu n yY\
INSPECTION REQUEsT:u", _~.ft,..rre
OFFICE: 726-3759
3.
COMPLETE FEE SCHEDULE BELOV
1.
W~TION' OF INSTALI.ATION
'(.,'10 Ol~
LEGAL DESCRIPTION
o ?, .z./p 4- "L
. A.
II
6 t.r7 (J '2-- '
~
10~m..ft. or less -L.
E~b~~tional 500
~~~1:.!@~ ~'p~tion ~
,# ~Ih,,^i~~'~ome. or
~ ~R..au~~lling'
.(5 q. ~r~~e'~-Feeder
~ (!>~.::t:'
~. '~~ices or Feeders
~~. tallation, Alterations
,.g; (>)b;ff Relocation:
~ ~ 'i>' .
Address ~1.L~ C~E:F~ e..e:, .:R ,~ ~"'9"""200 amps or less
~ : ~ 201 amps to 400 amps
City ~r~ Phone t.,f~ /7f:-P'.~ 401 amp's to. 600 amps
-'. . ~ 601 amps to 1000 amps
Supervisor License Number ("'?!f03 S Over 1000 amps/volts
J Reconnec t Only'
Expiration Date IO/qf<'
r JOB DESCRIP:rION
f\ e.w ~v-<A--"-
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 contractordJu~ (k.,Ll
Items
Cost
Sum
$ 85.00 . ~{" .-
$ l5.00f.~. -
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Constr, Contr. Number /03'11'7
Expiration Date /.://<;'8"
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600.amps or 1000 volts
Signature of superv~Electrician
~~(~
D. Branch Circuits
Owners Name
$ 40.00
$ 55.00
$ 80.00
see liB" above
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New, Alteration o~~Extension Per Panel
$ 35.00
Miscellaneous (Serviceifeeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Address
City
Phone
One Circuit
Each Additional
Circuit or with Service
or' Feeder Permit
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Ovner~~ignature:
-.
~
DATE:') ----d - ( (' : '1 <t
RECEIPT I:)., <q<? IA \
RECEIVED BY: 9)/~}
s.
SUBTOTAL OF ABOVE,
5% State Surcharge
3% Administrative Fee
TOTAL
'-.
$ 2.00
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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