HomeMy WebLinkAboutPermit Electrical 1996-7-17
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726-3769
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not starte~ within' 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor E.StA IlJG
, .,
Address\7~ln OAIL(.>1\1LH ~D
Ci ty b.l~()(. Phone YRS-S:S'll'L-
Supervisor License Number 5'1CJ- S,I<'o
Expiration Date \0--1- '11"...
Cons t r Con t r. Number \ \ \ 7- y,l,
Expiration Date 2..-2-9'7
City Job Number
ELECTRICAL PElUIIT APPLICATION
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3. COMPLETE FEE SCHEDULE BELOII
A.
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 Manuf'd Home. or
ModulaL- 'Dllelling
Service or Feeder
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
Reconnect Only
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
"
$ 50.00 ,.
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signature of Supervising Electrician
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OWneL"S Name (' ,T E !Z.e()h.,\ <;. StA. k~
Address \S'7tJ SOl.lm A S-\-.r<.eT
CitySP\';.n"'\;,~\o.. Phone '72L-'1~1\
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O\INER INSTALLATION
"
The installation is being made on
property I Olin which is not intended
for sale, lease or rent.
Owners Signature:
--------------71r-rT---~~-----------
DATE: .' 1..:_1.1.0 . ':1.10 /Itl, 11-
RECEIPT 1\: ~ ~
RECEIVED BY: )
200 amps"or less
201 amps to 400 amps -----
Over 401 to 600 amps ~
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
,
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::Nell, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5. SUBTOTAL OF ABOVE
:...... 5% State Surcharge
'e3% Administrative Fee
TOTAL
$ 35.00
--
$ 2.00
not included)
. !.
$ 40.00
$ 40.00 ~
$ 20.00
$ 36.00
4\).00
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