HomeMy WebLinkAboutPermit Electrical 1997-9-29
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The lollowing project as 0!Jbmlth',id ht\!a ~hQ f~lI{)WI!'ll'l
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DataC\- ~-=4-1 ELECTRICAL PERMIT APPLICATION
97417 '^
AJ..'2"e~~gnature. \ \ W\'ei ty Job Number ,17,/ _~,7 ?_
3. COMPLETE FEE SCHEDULE BELOV'
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
LOCATION OF INSTALLATION r//
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LEGAL DESCRIPTION
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1.
JOB DESCRIPTION '
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Permits ~re non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. ,CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City,
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name_dJ""IP(}'p?(" 7Jl'Ai6dh) D.
Address p-I?~ .7S~2
Ci ty ~ _ ;;,~~hone 7&:....,~
OVNER INSTALLATION'
The installation is being made on
property I own whi~his not intended
for sale, lease or rent.
Ovnerg~Signature:
') ~~-~~--------~----
RECEIPT #: /' I, ZZS40
RECEIVED BY: #l~-,
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
Sum
-..
1000 sq. ft. or less
Each additional 500
sq. ft ~r portion
thereof
Each Manuf'd Home, or
Modular,'Dvelling'
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
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
Beconnect Only
$ 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 d/'J.~O
$ 55.00 r
$ 80.00
volts see "B" above
Branch Circuits
,.
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with'Service
or Feeder Permi t
$ 35.00
$ 2.00
E. Miscellaneous (Ser~icejfeeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ~ {-o
5% State Surcharge (z 00
3% Administrative Fee I 40
TOTAL dc. LV
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