HomeMy WebLinkAboutPermit Electrical 1997-5-15
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759'
97477 Der..<I
72 6- ~l]...6.9)\'\ze.d Slgns.iUre.
1. LOCATION OF INSTALLATION
45r:j Lard/na 1 IAiy
17GtJ ~~JI!f -- OLf'-f 0 D
JOB DESCRIPTION
inS/Ail Sel'"u r,' +y
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
ELECTRICAL PERMIT APPLICATION
vl ty Job Number 0 707(0 S
3. COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included: .
It ems Cos t
Sum
1000 sq. ft. or less
Each additional 500
sq'. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ i5.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY' B. Services or Feeders
Installation, Alterations
Electrical Contractor Son it ro I Secu r i ty or Relocation:
Address P.O. Box 21009
City Euuene
Phone 461-5678
Supervisor License Number /108Q fEr
Expiration Date 10-1- 99
Constr Contr. Number 65149
Expiration Date"~&!2000
Signature of Supervising Electrician
,~~
Owners Name r:Y-/1 nK me L.t1 LUS
Address 18&,g P 51.
Ci ty ~ru1n(j(}f)1-Phone 13g-4tJ~1
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~---~/f~;f~-~----------------~
RECEIPT #:' U k~ -, elf -r '
RECEIVED BY: ,';;t(- ~ --=-
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 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 volts
$ 40.00
$ 55.00
$ 80:00
see "B" above
D.
Branch Circuits
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 or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limi ted Energy/Res ~ $ 20.00 ~V
Limited Eneigy/Comm $ 36.00
S. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
:20.0 0
J, t) V
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