HomeMy WebLinkAboutPermit Electrical 1996-2-16
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, , ,Z7~'hL!RJ ELEcrRICAL PERMIT AP. PLI,CATION
97477, d I ~ . ,-' C' [)( Q IJ..
726_376~me, ' V Ci ty Job Number J oR - )
Authorfzed Slr.,;.;."",~17
3 ~ ""4b-!tPrJrrE- ~~t:"""SeHEDULE BELOY
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
L IryI~l~ OMID1r~\_QL,
,r)A~~~~ION \\'dOCJ
~e~rn(lQn~ ~(f)':)8
A. New Residential-Single or ,
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq.ft. or less I $ 85.00 <as
Each additional 500
sq. ft or portion ~ 45
'thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
Permits are non-t~ansferable and expire
if work is not started within 180 days
of issuance or if,work is suspenoed for
180 days.
2..' CONTRACTOR INSTALJ:1.ION ONLY B.
Electrical ContractoC1)(jt1.flS EI..D.~
Addres~ \)~l\). ~ YA
Ci ty \hit ~ 0 j\X~~ "Phone 11lo'1~
Supervisor License, Number. ~ '3 5~
Expiration Date \D~ \.~
Constr Contr. Number ~ \0~~1~'
\(). R.~
Expiration Date
s~s?r~an
Owners {Jme \\S'f\ ~
Address c{)\C\~ ~ornr:~
CitY~~ Phone'lt-,ClIo~1
, OYN~~TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent. '
.
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 000 amps or 1000
D.
Branch Circuits
----
$ 40.00 c1tJ.~
$ 55.00
$ 80.00
see "B" above
volts
New, Alteration or Extension Per Panel
One,Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump 0 r i rriga ti'on $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm, $ 36.00
Owners Signature:
DATE: '2-/~'~
RECEIPT 1I: ~4:,~.,:
RECEIVED BY:
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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