HomeMy WebLinkAboutPermit Electrical 1999-2-22
sP.... ..GFIELD
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST
OFFICE. 726-3759
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~~CTRICAL PERMIT APPLICATION
Cl ty Job Number ~ q 0 d.-Lf y,
97.fDai'e
726-3769
nuthonzed Slgnaturo
3
1. LOCATION OF INSTALLA~ION
on (' Q l'\rl11 ("\CW) 0 "?-,\\y\ 10..0 ~,rc 0 \1.f.on.JA.
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\ LEGAL DESCRIPTION no,,;> 1-'0
70s 'd.-S 53 qDCo'O-CSD ?JL.I ,.d.,J.CJ()
JOB DESCRIPTION
"'\~~ no Son I f\ rb I
PermIts are non-transferable and expIre
If work IS not started wIthIn 180 days
~Jl~~nce or If work IS suspended for
THIS PERth SHALL EXPIRE IFTHE WORK
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Cf,r~~~~t-l~:il106dr; t'',!1''c''m~sRrf0fl r 0 I See u r 1 t Y
ANY 180 f)t PF:RIOi'
Address P O. Box 21009
C1 ty Euuene
Phone 461 - 5678
SuperVIsor LIcense Number IL~~
Exp1lat1on Date \()l~
Constr Contr Numbel 65149
Expua non Da te
6-28-00
SIgnature of :~~Slng ElectrIcIan
~~-~
~
Owners Namffi~t>\'\'O(~ 0
Address Ii II (O.n n-\{)"ru.""O
C1 t~n trvtotrl Phon;\L\ \ -qjd~
OVNER INSTALLATION
The 1nstallat1on IS beIng made on
property I own WhICh IS not 1ntended
for sale, lease or rent
Owners SIgnature'
-------~-------------------------------
DATE Z:-L'Z-~-O{;\
RECEIPT jf: n~?- '" -? 5-
RECEIVED BY' '(\ ,~\('c~.-,~\.N
COMPLETE FEE SCHEDULE BELOV
New Resldentlal-S1ngle or
MultI-FamIly per dwellIng un1t
ServIce Included
Sum
Items Cost
B.
1000 sq ft or less $ 85 00
Each addItIonal 500
sq ft or portIon
"''''~'iE!?WiON Oregon law reqUires y~ tj>5 00
~8w~ilnWadbptem0Ydhe uregu" Utility
N \t~ @e'i'It:e:J.rfiglse rules are set forth
In 1i:F\~_&1-5\}'i'd~ough OAR 95~.0Qj1-o0
amlO You may obtain copies of tne rules by
:s~,.t\'I~S;~ihli'ceI\OO<!{NGte the telephone
In~~ Ti'r~b~fWlo~E!M\'YINotl!lCatlOn
of'l1Wi 1Jc~~i'e9?s 1_800-332-2344)
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50 00
$ 60 00
$100 00
$130 00
$300 00
$ 40 00
C. Temporary ServIces or Feeders
Installat1on, AlteratIon or Relocat1on
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40 00
$ 55 00
$ 80 00
see liB" above
D. Branch C1rcults
New, AlteratIon or ExtensIon Per Panel
One CIrcuIt
Each AddItIonal
CIrcuIt or WIth ServIce
or Feeder PermIt
$ 35 00
$ 2 00
E. MIscellaneous (Serv1ce/feeder not Included)
-Each InstallatIon
Pump or IrrIgatIon $ 40 00
SIgn/OutlIne L1ght1ng $ 40 00
LImIted Energy/Res $ 20 00
LImIted Energy/Comm $ 36 00 ~
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Adm1nlstrat1ve Fee
TOTAL
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