HomeMy WebLinkAboutPermit Electrical 1994-5-24
J~~i~o"oWjng project as submitted hal?; ~h< '''!bv.tl,
225 FIITH STREET. g, and does not require s......."/.c' ELEI,;Tl<.'N;AL
approval. ..__n la....... '0.'.
SPRINGFIELD,.OREGON 97~77 ~/1
INSPECTION REQUEST: 726-3769 Zoninp LV Ci ty Job Number.
OFFICE.:' A..26-375. ~ . -'.-f.'ates--~}"-I
'~ Xj \~)~ 3. COMPLETE FEE SCITEDULE BELOV
1. L9cA'QON I.STALLATI. O~~nature U.M. . ..
.qr;..i/l:lrl ~ .~..Pt:tlAkJ- {Jh.f- A. New Residential-Single or
tfe. . 44 Multi-Family per dwelling uni t.
\(\LEGA..,L DE cRijjfio~ A/l() Service Included:
. \D~\ ~0()'-......CX~ Items Cost Sum
JOB DESCRIPTION
Sj~h 5
Permits are non-transferable and expire
if work is not started withi~ 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
~
Elcctrical Contractor Mtitll"ft'... &ti.(. /~
Addl'css . ttJ'-f .Je{{,HfJ""
Ci ty .6_I/tQIWl
(1.
Phone. 3'12- {7J4-
Number if tr3r 5
Supervisor License
Expiration Date
Expir~tion Date
CciIM f(
~.q.~
Constr Contr. Number
Signature of Supervising Electrician
~~ J:twd
Owners Name {~C, tfP(<k1.111cP""fJ
Add ress t;{;AOJ ).Lv. W{Jj~(rJe
Ci ty IfflivevfDlf\. Phone hill
OVNER INSTALLATION
The installation is being made on
property I own which is not iniended
for sale, lease or rent.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations or
Relocation:
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
.$ 35.00
$ 2.00
not inCluded)
$ 40.00
$ 40.00 ~
$ 20.00
$ 36.00
2'(1) '...0
--------, . e::.-~-~-A--------~----- 5. SUBTOTAL OF ABOVE <..y-.;e AID
DATE: :--.....J~. -.-.'~..". _c.'J.4.~_I~_~ .-.... 5% .State Surcharge _'-I. - ~B'. '\
. RECEIPT #: ,It. ~-~- ~:.~- J.~~ . 'tOTAL, . ~VlL( ~
RECEIVED BY:__L.; .. ~'~.A .. J [5. l"'\n ~~~I\LoOr\) ~\~~ .
c'._C.' . ~c9.~~~-t>.QXVf\lt~'j
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
D.
Branch Circuits
Owners Signature:
One. Circui t
Each Additional
Circuit or with Service
or Feeder Permit
E.
H~scellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting~
Limited Energy/Res
Limited Energy/Com~