HomeMy WebLinkAboutPermit Electrical 1999-12-13
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Date - /1--('; 'C; '" P.LE~CAL PERMIT APPLICATION
97477 AUfrjOn~ed ' :.....J.
726-3769 Signature ~ n '-~ -.Job Number Cf'Uf 0 Nl ~
3. COHPLE~ SCHEDULE BELOV
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION /I ~
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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 0 lUll...Q.A../
Address'
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name Up y V\
Cny t'\ JI ,U lUJ--
BV'~ s 00~
Phone 7t! 19 ':'-1 ()~<t
Address
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Ci ty ~ L--et
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OVNER INSTALLATION
The ins talIa t ion is being made on '
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT #:
RECEIVED BY:
I~- 13-94'
o3tatJ I ?~
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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 Manuf'd Home, or
ModularD~elling
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
Reconnect Only
Items Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00 9.-
$ 60.00
$100.00
$130.00
$300.00
$ 40.00 ,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' COT 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
D.
Branch Circuits
New, Alteration or Extension Per Panel
,.
One Circuit S 35.00
Each Additional
Circuit or with Service!
or Feede'r Permi t rf $ 2. 00 $l~.
-
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$ 36.00
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40.00
40.00
20.00