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HomeMy WebLinkAboutPermit Electrical 1996-1-10 ~ ~ ~.. . ubmmer.l \"Ins the 1oll0wl ine ~o\\owlng pr~~~ ~~uira specific land \.ISO '1(,,,';-;:1, and doe .. ",. ,0' "'ZOOlog~ A li2? ELECTRICAL PERMIT APPLICATION 97477 ..... 1.//0 -: q f?/ . 726-~76~ '. L). -(3i..y-:1'ob Number 15-/55'1 J.\1.l1.f\orlted s\gnatura-:- f-R'T . 3. COMPLETE FEE SCHEDULE BELOY 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. Lo.C,ATION OF J:!,/STALLATION ~S5G ,~ ~ !tJ7 LEGAL DESCRIPTION /?-z?2-~-:;>~ ~ "t'_"")~-Z . , . / - JOB DESCRIPTION ~. '4~/'ff/o/~~p~ #b~ .~~~e ' . Permit ~~n~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 ~fV ~ ~ /~.~~ '. Phone 72-1 .-/SOV Number 7'rf.t".-S /2-/f'6 / Constr Contr. Number ~"-,;28CJC:.- / 2..-/ f (;, Address /O~ Z- Ci ty ~ ~ rr Supervisor License Expiration Date Expiration Date Signature ,of Superv~sing Electrician ~. ~ -. -- / /J /~6a'//#/JlfI~ D. Owners Name .~..' .. ~ Address I~ 77 ,~ . ?7. . City ~rLD' Phone"7.Y6~~9/ OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent: Owners. Signature: --------------------------------------- DATE: RECEIPT #: RECEIVED BY: /-~,~ rL~c.;:>--'" ~ /7~ A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 sq. ft. or less Each additional 500 sq.' ft ,or portion thereof _ Each ~me or . Modular. Dwelling Service or Feeder 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 .Reconnec t Only Items Cost Sum $ 85.00 $ 15.00 ? $ 40.00 ;fi!i::P... ~ $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alt~ration.or Relocation 200 amps"oT less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above Branch Circuits New, Alteration or Extension Per Panel " One Circuit $ 35.00 Each 'Additional Circuit or wi th Service _'0 or Feeder Permit / $ 2.00 --z... . Miscellaneous (Seivice/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL not included) $ $ $ $ -.a 7. ca.Q. '(_ (0 :;2.% ~~.~ 40.00 40.00 20.00 36.00