HomeMy WebLinkAboutPermit Electrical 1997-5-21
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST
OFPICE: 726-3759
Da'e <., -;) I~
I\uthortzed Slgnature~'M
97477
726-3769
1. .J.OCATION 01; INSTALLATION d
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Perm1ts are non-transferable and exp1re
1f work 1S not started w1th1n 180 days
of 1ssuance or 1f work 1S suspended for
180 days
2. CONTRACTOR INSTALLATION ONLY B.
Electncal Contractor ~/LIf'5 b.&z/R..c...
Address . ":)/7D ml-:/>rOow L-rJ
C1 ty 1::u.r'7I~c Phone (af?~ -(,,/ J...J
SuperVlsor L1cense Number 27/ '1'::'
Cons tr Con t r
~ IO/Q7
Number '2o-j '7 9 C
.~q/lllq7
Exp1ranon Date
Exp1ranon Date
Slgnature o[ Supervlslng Electrlclan
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N.1T/1"'" ,fHf,-d'5 & D.
Owners Name rtt/Mtti) lhCLIJ.J4Y
Address 211L( CtM-10,Yll'ol Slve/
C1 ty ~(\ ~,\-H uld Phone 7tfl{ - 2/2.-2-
OIlNER I~ALLATION
The 1nstallat1on 1S be1ng made on
property I ovn whlCh 1S not 1ntended
for sale, lease or rent
Ovners Slgnature.
------------~--------------------------
DATE: 5..~I-q7
RECEIPT tt: .z5S~q
RECEIVED BY' V~
FTZ6'FRICAL PERMIT APPLICATION
Cl ty Job Number
Cf7D 80 /
3. COMPLETE FEE SCHEDULE BELO~
A. New Res1dent1al-S1ngle or
Mult1-Fam11y per d.ell1ng un1t
SerV1ce Included
Items Cost
Sum
1000 sq ft or less
Each add1t10nal 500
sq ft or port10n
thereof
Each Manuf'd Home or
Modular Dwell1ng
Serv1ce or Feeder
$ 85 00
$ 15 00
$ 40 00
Serv1ces or Feeders
Installat10n, Alterat10ns
or Reloca non
200 amps or less $ 50 00
201 amps to 400 amps $ 60 00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130 00
Over 1000 amps/volts $300 00
Reconnect Only $ 40 00
C.
Temporary Serv1ces or Feeders
Installat10n, Alterat10n or Relocat10n
200 amps 'aT 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
Branch C1rcu1ts
Nev, Alterat10n or Extens10n Per Panel
One CUCU1 t X. $ 35 00 35'
Each Add1 tlonal
C1rcu1t or w1th Serv1ce
or Feeder Perm1t l - $-200-'2.-
E
M1scellaneous (Serv1ce/feeder
-Each 1nstallat1on
Pump or 1rr1gat10n
Slgn/Outl1ne L1ght1ng
L1m1ted Energy/Res
L1m1ted Energy/Comm
not 1ncluded)
$ 40 00
$ 40 00
$ 20 00
$ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Adm1n1strat1ve Fee
TOTAL
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f II
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