HomeMy WebLinkAboutPermit Electrical 2007-9-17
ZON
INITIALS
DATE
SOURCE
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ~2-LJe)h-071b
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2-71-4 C ST
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JOB DESCRIPTION:
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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.
5/17/07
Date
3.
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$117.00
$ 21.00
$55.00
B.
Electrical Contractor CJfXIS
Address 7~~,~ 72a1 ~
. , .
City ~ Phone Z4~-Jg.7L
'1 B~i;r')t:Uc1;200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 Amps/V olts
Reconnect Only
(supervisor License Number L/ 7 5-- 9' s
10/;/ / '2-{H[)
Constr. Contr. Number I S7; 9 () ()
()~ /1 {) /2-/ C)
I /
Signature of Supervising Electrician
Expiration Date
( Exp;rnHon Da"
\( CkkC(-f~
Owners Name 5ra/a) CA:5'5EtL
-
Address /*r ~~ ./ ~/).AJ y ~
City 'pf~. ~7401 Phone~S7- I'IJ"S
Inspection Request: 726-3769
$ 70.00
$ 83.00
$138.00
$180.00
$413.00
$ 55.00
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2~o~~\O~~~~1~(\ COQ~. \"e \t,'1\\\C~6.00
4~o\~~~~&~et. ~o'\)'(\\\~A)' $110.00
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Ov~~.~~ ~ 'B" above.
D.nmB.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
E.
$ 55.00
$ 55.00
$ 28.00
$ 50.00
Fee is $50.00 + Surcharges
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07.doc
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