HomeMy WebLinkAboutPermit Electrical 2006-5-31
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3. I COMPLETE FEE SCHEDULE BELOW
, <> CITY OF SJ1RINGFIELD, OREGON '_.1
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH,(541)726-3753 . FAX, (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number CO""",- z.oes b - 00411
I. I LOCATJONOFINSTALLATJON
~50 A- ~t-
LEGAL DESCRIPTION
/7D"33 ~32
JOB DESCRIPTION
02. 700
Se- tt. \f l c...e
Gl-+A- N G-<:!'
Permits are non-transferable and expire if work is
not started within 180 days ofissuance or if work is
Suspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY I
Electrical Contractor t h )t./ 5. f 41.\0>1 ~ let: ItL '(
Address <<al n
City ziul.h.-.( J
. ~, f)hdJ I v1v-e-
Phone G~~ ,(p 1:>- \
Date
A. I 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 Manufact'd Home or
Modular Dwelling Service or
Feeder
$106,00
$ 19,00
$50.00
B. I Services or Feeders - Installation, Alterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNollS
Reconnect Only
$ 63,00
$ 75,00
$125,00
$163.00
$375,00
$ 50,00
7S-
I
Supetvisor License Number lID??.s c. I Temporary Services or Feeders
?1 O\l 10
ExpIration Date Ie;) [) 7 ,~," (ec,\.l\(e: '! \.llil\l,! Installation, Alteration or Relocation
JI' .. (j''''''- fI \ (\"
\ O(r.y" ,\I,e' e set 0 200 Amps or less $ 50,00
r "'.. ..vi:fi \ sax 00'-
Constr, Contr, Number ".. c,~ ".:. A.del\l e _ ':'.952' 201 Amps to 400 Amps $ 69,00
t \,,':' ,",uP' \ 5'0\1
\ ' ,~'_, ,3' \('1\0\.\9 ~ I'fIZ (\l e 40 I Amps to 600 Amps $100,00
EXPi7ati Date _ '~'IC :..: r "f'fl ~~('"es 0 ,~,,'fIOfleO 600 A 1000 V I "B" b
. . .:.(,' \'3.\\\....... t\\e ~Ol'-'r' \\, ,yer mps or 0 ts see a ove.
~ {" 1', ,'1 ,0 1~10\8. ~IO\\\\C?-D f B h C' '(
S7. ature of p. , 1 . _ ectnc ... n!"'\tet. ,\'10 \\\t'} \"l . rane Ircm s
v ,. Ir' 1,,- Ofl \.l\ 1\1\')-
J c'" ~(\ \~( \'fIe o(eiOO_'3'32-2'3 New Alteration or Extension Per Panel
7, 1\00\.. ~\,,( \S \ - One CIrCUIt $ 43,00
bL '/ v~' Each Additional Circuit or with
c::: I. n Service or Feeder Permit $ 3,00
ers Name ..:>'^- \...)
Pump or irrigation $ 50,00
Sign/Outline Lighting $ 50,00
OWNER INSTALLATION Limited Energy/Residential $ 25,00
The installation is being made on property I own which Limil\~ ~I1~g~)~~';I'ercial $ 45,00
is not intended for sale, lease or rent. MiDi'rn:h~Elec011 ~~r.mit Inspection Fee is $45.00 + Surcharges
\c,I{;.', S\>',1,\).~. ,<, 91"'" 'in""
~C)\ ?t.\\~~\1 \I\,\ljt~ t SUBtOTAL OF ABOVE
1'0\ V0\\\1't.1j lJ\\ \'0 ' ~. ,
1>.\11\ "t:~C,'t.1j ?t.\\\lJ\8% State Surcharge
C,\)W~I\~\) Ijl>.'{ 10% AdminIStratIve Fee
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Address
t=>o i"3..~ ~O'D
Phone 71.{l.{- 5"ZZi
City
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Owners Signature:
Inspection Reqnest: 726-3769
E. I Miscellaneous (Service/feeder not included) -Each Installation I
7:)
b
TOTAL
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Shared Drive(T:)/Building FonnslElectrical Permit Application I-06.doc