HomeMy WebLinkAboutPermit Electrical 1991-3-29
225 FIFrU STREET
SPRINGFIELD, OREGON 97477
iNSPECTION REQUEST: ,726-3769
OFFICE: ' '726-3759
1.
LOC^fS~ ~F ~~~
ELECTRICAL PERMIT APPLICATION
City Job Number 'Q\O\9<?:'
3.
COMPLETE PEE SCUEDULE BELOY
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A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
""~B Q~CRIPTION '
I \" . t-" OL)/ .
;er:: a~e non-transferable 'and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Elec tri~al contractorL NV\f\~ wt
"AddressQa ~;;rJ-'-'- ,
City~ ~J\L-" ,PhoneJalo~lffi
Supervisor License Number ~ ~~~
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Gonstr Contr. Number 'CJ.3 \ () J
'\0/5/Q /
Expiration Date
Items Cost Sum,
1500 sq.ft. or less $ 85.00 8fj
Each additional 500
sq. ft or portion ~ "30
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 35.00
Services or Feeders (10 Branch Circuits
included). Installation, Alterations
or Relocation:
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00,
$ 60..00
$ 90.00
$130.00
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising,Electrician
i:e~f~~
Address. A4G.. ~ .(b 1\ Y'.u'Xi '~-' .
Ci ty\), '~1 ~ ':, Phone 'le.f{)~.~ q,)?
OVNER INSTALLATION
The installation is being. made on
property I ,own which is not intended
, for sale, lease or rent.
Owners Signature:
~A~~~----(3;r~L1j1'1rJr----~----------
RECEIPT I: I I (ff) V'l'-1
RECEIVED BY: ~/
.'
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B"
D.
Branch Circuits
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limit~denergy panel
One Circuit
, ,Two to ten Circui ts
Each Addt'l ten or
portion thereof
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 50.00
$ 15.00
not included)"
$ 36.00
$ 36.00
$ 36.00
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