HomeMy WebLinkAboutPermit Electrical 1996-12-13
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97i;7)-::ti~.i~(..... - ELECTRICAL PERMIT APPLICATION
7/2.68J7693ignU!Uro-il.J11-1I.A.- \..ny . Job Numb."r q ro ! 51(9
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 7Z6-3759
IiI WCATION OF ,J;NSTJiLLATl;ON
_pOl-( 0 So/JIll 1+ ~t-
LEG{j.i.., DESCRIPTIQ,N
17DjJ0-:S1 (JrouoO
,JOB DESCR.IPpjlN " L
(I) 1151 arid,"'" {!MILZ acfrjjT
- I -
3. COMPLETE FEE SCHEDULE BELOII
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Fermits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Z. CONTRACTOR INSTALLATION ONLY B.
Elec trical Contractor \).,P \ \\\tJ\c1:') fl()~
AddressB~ 0p~\ \\lDd
City D 'f1~O~ Phone ?A:u2QJ
Supervisor License Number ~~{J~
\\\. \ .
Cons t r Con tr. Number \"\ 1J... ~_
h'~'
Expiration Date
Expiration Date
Signature of Supervising Electrician
(k.d~~
.0wne~mer~UrtM~./ J")S
Address_[~ .) ,,<),/.d11 A- Sj-
Ci tx':::;-pn dfl Phone
OIlNER
The .installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: I'z/l3-4k
RECEIPT #: 'It.{n'1 [
RECEIVED BY: ~ V-'
Lr'
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
ZOO amps or less
ZOl 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
S 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
ZOO amps. 'OT less
ZOl amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100U
D.
Branch Circuits
New, Alteration or
$ 40.00
S 55.00
S 80.00
volts see IIBII above
Extension Per
(
Panel
$ 35.00 :qt::
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Servic~
or Feeder Permi t ")
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
/
$
(()
2.00
no.t included)
S 40.00
$ 40.00
$ 20.00
S 36.00
_ 4.5.riD
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