HomeMy WebLinkAboutPermit Electrical 1996-5-9
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225 .~.Lt.LO STREET appr'=>'!e.!. , r?:::::::. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 zon ng' .
INSPECTION REQUEST: 726-3tfis? 5 .~ Ci ty Job Number 96 ell ~ 0
OFFICE: 726-3759 ..;' :, ~ ' '. ~
_ ',> ~~~ ___~ J. 'KJ!'~E FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
,;&34-4 BEV/{/b<-l! sf)
A.
New Residential-Single or
Multi~Family per dwelling unit.
Service Included:
"-.
. ~' DESCRIPTION
/7 tJ 6 ;;no d~
() Lf7 (J1)
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof. $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601. amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
JOB DESCRIPTION rI
/1 JV5 J.6 /l- /i .EO/( Y1 /110 OJ TI ~ ' ,
- . .. -
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
I 2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor (;~~pc 6J~6f~i~
Address ,~5S f SheV'WlAV1
City kbA-ncm Phone J.j,S/- 3023
, Supervisor Licen.se Number ,151/.s
Expiration Date /O-/-qg'
Constr Contr. NumbeCffJ1'1/!2..
blur. C"J~C.
- .2~-/3J./ t
Temporary Services or'Feeders
Installation, Alteration or Relocation
Expi'ration Date /CJ :-: L.j~ 96
200 amps or less
201 amps t~400 amps
Over 401 to 600 amps
Over 600 amp~_or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
I - . - . .. .... .'
Signature of Supervisi~Elec~rician
v< ;Y~Jl ~/a~
'. Owners N8;me. ~~ ~
Address ':2 Ji#-. /~~
. f
City' 5f/.?7 'Phone' 72.t',.-1-/SJ'
OWER INSTALLATION
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit; I $ 35.00 .is. /)0 .
Etich Additional . .
Circuifor with Service
. or FeederPe.rmi t . .3 '$ 2.00 "- IJ1 ()
. f. I
DATE: <5)q /0Jv , , )
RECEIPr i:{j,J i q~ 6""i,..,
RECEIVED IiY f r), m ~'('Y'i(J dV
E. . Miscellaneous (Service/feeder not included)
-Each install~tion
Puinp or. irrigation $40.00
Sig~/6u~}in,~Lighdng $ 40.00
Liiu ted Energy/Res .$20.00
. Llnii ted EnergylComm $ .36.60
5.. SUBTOTALOF'ABOVE ~. ,,/)
5% 'S ta teSurcharge dl .. B.s-
....: ,::rO,T~, ,'.... ' . J_ '}"'3
... +30h'Mm\f\~~#. ,;2-8'
The. ins talla t ioil is being made on
property~ ownvhich is not intended
for sale, 'lease ot rent.
Own,ers Signature: