HomeMy WebLinkAboutPermit Electrical 1997-1-13
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o.<eJ_ 'Tl11i ,j) rIf'~ ELECTRICAL
97~.z?lO\lzed S'nnaUre 1\
726-3769 C1ty Job Number
225 FIFTH STREEf
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE 726-3759
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/ifr3~ff,~I~ ,~3()O
r I ~JOB DESCRJ,f'TION(I "-IJ---..
\.()t!"n J 1, (v} /I A 1~
pel~ts are non-transferable and explre
1f v rk 1S not started vlth,n 180 days
of ssuance Ol If vork 1S suspended for
180 days
EXp1ratlOn Date
The Installatlan 1S belng made on
property I ovn VhlCh IS not Intended
far sale, lease ar rent
Ovners SIgnature:
-----.------------------.----------0<\---
DATE: __ ~\.\~
RECEl...! ii: h "'HAl \ ' ~ "!: ~_:
RECEIVED BY: v ~'J\ '!oJ '\\DJ'-!
PERMIT APPLICATION
Q 10/110
3. COMPLETE FEE SCHEDULE BELO~
A. Nev Resldentlal-Slngle or
Multl-Famlly per dvelllng unlt
Servlce Included
Items Cost
Sum
1000 sq ft or less $ 85 00
Each addltlanal 500
sq. ft ar portlon
thereof $ 15 00
Each Manuf'd Home or
Modular Dvelllng
Servlce or feeder $ 40 00
B.
SerVIces or Feeders
Installatlan, Alteratlons
or Relacatlon
2. CONTRACTOR INSTALLATION ONLY
Electocal CantractClr1\..oJlt I Pl Q~
Addrt:.s \C\I\() ?~~-\t\ 8 -,-' .'
C1 t~~ 11..- Phone\4I.221:::)
supel-Vls~))Llcense Number ~~
\.D. \ .Q'
Constr Contl Number t ~('''\ ~
Exp,lratlan Date ,~.~'). ..,7
sikLature of Supervls1ng El:ctrlclan
\ 1 1J/ /fIlriHItMJb;~
lrer~ N\~e~J(.t\UuJ
A dresj)1'i{tJn rOmf/J1fJ71i-
1 ty h )(]fJ1Jl---- Phone
O~ QNSTALLATION
200 amps ar less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
C.
$ 50.00
$ 60 00
$100 00
$130.00
$300.00
$ 40 00
Temporary Serv1ces or Feeders
Installatlon, Alteratlon or Relocat1on
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 Clrcults
Nev, Alteratlon or Extens10n Per Panel
Mlscellaneous (Servlce/feeder
-Each Installatlon
Pump or lrr1gatIon
Slgn/Outllne LIghtlng-----
Llmlted Energy/Res
LImlted Energy/Comm
One Clrcul t I
Each Addltlonal
CIrcu1t or vlth Servlce~
ar Feeder Permlt ~ )
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Admlnlstratlve Fee
TOT AT
$ 35 00 ~
$ 2 00 k
not Included)
$
$
$
$ 36 00
41DO
1 ()~
A'7j
44 z.<;r
40 00
40 00
20.00