HomeMy WebLinkAboutPermit Electrical 1998-7-7
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SPRINGFIELD
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225 ~ "/l1flv. v UNO C)(PIR, ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9741!J1r 1Rc; CfOOR 'fIT rHIS 'E:lf:/Hf [}dO 5"-'
INSPECTION REQUEST: 726-376'1 O..q y p ISI18. PE:R4t, ~ Job Number -I 1) cA. I
OFFICE: 726-3759 E:~/Of) 'ljNOoA, ~rlS M~
3. 'v'6o>,lIQ,fWFEE SCHEDULE BELOII
1. LOCATION OF INSTALLATI,\JN *
I'l. 00 (I, ~ <<--I' )-
LEGAL DESCRIPTION
/7 ()?., ?-<S'3 40~ 701)
JOB DESCRIPTION
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Perm1ts are non-transferable and expire
lf work 1S not started w,th,n 180 days
of 1ssuance 01 1f work 1S suspended for
180 days
2. CONTRACTOR INSTALLATION ONLY
Electr1cal Contractor
Address
C1ty
Phone
SuperVlsor L1cense Number ,,;ZOO~S
Exp>rat10n Date_ dI!!f 10- 9 J?',
Constr Contr Number r2 0 - j, '7 R'C-
Exp>ratIon Date /0- 9?1
, -
SIgnature of SupervIsing ElectrIcIan
aJau,u: /: t2/~
owne~Name CJ ~.".-<.A1.. (3<._~",:t
Address 1'61lD ('~~...JJ -J:t '--
Clty~+;~ Phone '7:2.(" 50SS
O\INER INSTALLATION
The Installat10n 1S belng made on
property I own Wh1Ch 1S not lntended
for sale, lease or rent.
Owners SIgnature:
DATE~-------1~'7~--Ci-~----------------
RECEIPT 11: '\ ~\o'6'V
RECEIVED BY: '-f\LIJ
A.
New Resldentlal-Slngle or
MultI-FamIly per dwellIng
SerVIce Included
1000 sq ft. or less
Each addItIonal 500
sq ft or portlon
thereof
Each Manuf'd Home or
Modular Dwelling
SerVIce or Feeder
B.
SerVIces or Feeders
InstallatIon, AlteratIons
or Relocatlon:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 ampslvolts
Reconnect Only
unlt
I terns
Cost
Sum
$ 85 00
$ 15.00
$ 40 00
$ 50.00
$ 60 00
$100.00
$130.00
$300.00
$ 40 00
C.
Temporary SerVIces or Feeders
InstallatIon, AlteratIon or Relocat10n
200 amps 'OT 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 C>rCUl ts
New, AlteratIon or ExtensIon Per Panel
One CIrCUI t
Each Add1tIonal
CIrcuIt or wlth Servlc~
or Feeder PermIt '-1
$ 35.00 ~,-
$ 2.00 $I~.-
not Included)
MIscellaneous (ServIce/feeder
-Each lnstallatlon
Pump or Irrlgatlon
Slgn/Outllne LightIng
Llmlted Energy/Res
Llmlted Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% AdmInIstratlve Fee
TOTAL
40.00
40.00
20.00
36.00
$
$
$
$
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