HomeMy WebLinkAboutPermit Electrical 1998-4-14
The following project as eubmttteclhas tho foil
zoning, and does not requIre ~fflg'~-d
approval. " ""P""'- ..... use
Zoning \ rJ.... 1\1
. Date 4-, \ '1 .-tt t
97477 Autho, rized Signet V'I If\.\
726-3769. u~1 I. \
ELECTRICAL PERMIT APPLICATION
225 FIFTH STREET
, '
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: .726-3759
q~/53
r;.!v .Job Number
3. COMPLETE FEE SCHEDULE BELOV
LOCATION OF INSTALLATIO~
hOe; .J". "A-f"~b (!YR.
LEGAL DESCRIPTION
/702 35" 1'.1 I?<J~
JOB DESCRIPTION
/L??1.~ ~/z./(
1.
New Residential-Single or
Mul ti-Family per dwelling uni t.
Service Included:
A.
Sum
Items Cost
$ 85.00
1000 sq.ft. or less
Each additional 500
sq. ft or portIon
thereof
~ach Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 15.00
Permits are 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
.$ 40..00
B. S~rvices or Feeders
Installation, Alterations
or Relocation:
Electrical Contractor
$ 50.00
$ 60.00
$100.00
$130.00
$300.0.0
$ 40.00
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps'
Over 1000 amps/volts
Reconnec t ,Only
Address
Phone
City
Supervisor License Number
Expiration Date
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
/Q'\ ,~O
:) /.-/' $ 40.00 (u
$ 55.00
$ 80.00
volts see "B" above
200 amps' 'or less
201 amps to 400 amps
Over 401 to 60.0 amps
Over 600 amps or 1000
Expiration Date
Signature of Supervising Electrician
Branch Circuits
D.
,.
~A:?/f z;?;v~~.
, I
Owners Name
New, Alteration or Extension P~r Panel
,Address
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
Ci ty Phone ~'7 .) -:3~
OVNER INSTALLATION
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.0.0
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limite4 Energyltomm $ 36.00
5. SUBTOTAL OF ABOVE ~~
5% State Surcharge ( -::2. &0
3% Administrative Fee 1.2'iJ
TOTAL ..,d'''{ 2.,0
( '*""
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DAiE~---------~-~-~-~-----------
RECEIPT #: ' / . ( --:z Cf."1- 2- '2...
RECEIVED BY: . /~A .
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