HomeMy WebLinkAboutPermit Electrical 1996-8-2
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225 'FIFTH STREET
SPRINGFIELD, OREGON'
. INSPECTION 'REQUEST:
O~FICE: 726~3759
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97477 ,Au1nomoo Signature
726'73769
1. , LOCATION O,F !NSTALLATION"'/) ,
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LEGAL DESCRIPTION
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JOB DESCRIPTION ~' '
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Permits are non-transferable and expire
,if work is not startep within 180 days
of issu~nce or if vork is srispended {or
180 days. '
2. CONTRACTOR INSTALLATION ONLY
"Electrical Contractor ~~~<
Address
City
, Phone
Supervisor License Number
Expiration Date.
~onstr Contr. Number
Expiration'Date
Signa ture of Supervi'sing Elec'trician
Owners Name F'~~.c:.. '~..qz>y
, -: -... #';/ .. ... .-
'Address /2/2~~~.4""~ '
Ci ty 5~~- ~~Phone ? V?-/~.52:? '
O\lNERINSTALLATION
The installat~ory 'is being made on
property I own whi~h is not intended
for sale, 'lease or rent.
'Ovoers Signa\ure:
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DATE: ,', ~~2-~G._' ,
RECEIPT #: -Z "2;:?o/:Lft
RECEIVED BY: /L~ '.
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ELECTRICAL' P~IT APPLICATION
City: Job. Nuni~er, ?'~/~
3. COMPLETE FEE,SCHEDULEBELOY
.~
New Residential~Sirigle OG
Multi-Family per dwelling unit.
Service Included:' II
A.
"
1000 sq.fL or l'ess
Each additional 500'
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dwelling,
, Ser~ice or Feeder
,I
B. Services or Feeder~ ,
, Ins,talla t io'n, Altera dons
'or Relocation: '
,/
200 amps or less
,201 amps to'400amps
401 amps to'600 amps
601 amps to 1000 ~mps
-Over 1000 amps/volts
Reconnect Only
I t'ems
Cost
Sum
$ 85 . 00 .
$ 15.00
$ 40.00
$ 50..00
$ 60.00
$100.00
$130.00 '
$300.00
$ 40.00 '
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C~ Temporary'Service~ or Feede~s
rristallation, Alte}ation or Relocation
11'
200 'amps"or less '$ 40.00
201 amps to 400 'amps , . $ 55.00
Over 401 to 600 amps $ 80.00'
Over 600 amps or 1000 volts see "B" above
'D.
Branch Circuits
,.
New, Alteration'or':Extension Per Panel
/
One Circuit, .e.--:- $ 35.00 ~.S'~'
, Each Additional _
Circuit or with Service
or f.eeder Permi t' $, 2.00,
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
E.Miscellaneous (Service/feeder
-Each iristallation.,
Pump or irrigation
Sign/Outline Lighting
Limi ted 'Energy/Res'
Limi tedEnergy/ComlJ1 '
$
$
$
$
5 s. O"d>
/ .?$'""
j . e::J 5"" I
~?,,~~
'40.00
40;00
20.00
36.00
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