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HomeMy WebLinkAboutPermit Electrical 1996-8-8 ~ zc~in~, and does not require specific land use approval. Zonina f''\ ~ Date )C;' ~ ''1 V . 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 9747 tuthOrlzed Signature, 726-3769 1. LOCATION OF I~~;fION -3 ~ ':l, '2. . ~ ____ _ .., . 1 ,-"" / LEGAL DESCRIPTION / 71'23 /- ':? 07""" ~cw O~eJ20. JOB DESCRIPTION 72i: A,., ~ ,I(J {~/~~ - 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 Contractor Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name c::: t:/ I"..A-:", } , .....- ( ~# y The installation is being made on property I own whi~h is not intended for sale, lease or rent. Owners Signa ture: , ./ ~\"f! n . A~ GLr-ik h ~~~~~~--~~--------------~------- DATE: ~/~r~ ' RECEIPT tt:( '{ '~.,2.~93 . RECEIVED BY: ..#"'~ ELECTRICAL PERMIT APPLICATION City Job Number/bt'J93 r A 3. COMPLETE FEE SCHEDULE BELOY 7N\ A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion' thereof Each Manuf'd Home. or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 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' 'or less L--- $ 40. 00 4tJ~ 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits ,. New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with 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. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administ(ative Fee TOTAL $ $ $ $ 4.0 tJ /f) , 2-~ / 2..1) ~ ~ ,'1-/1)- 40.00 40.00 20.00 36.00