HomeMy WebLinkAboutPermit Electrical 1995-12-4
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3pproc:l~i .... '-"'\':d nc. require o~~rt'c land
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I ;;;Ut/, fC-/ ELECTRICAL PERMIT APPLICATION
97477 Dot"_'---t--f~
726-3769.u1honZedS,gnst CIty Job Number (l~ o'6?-...
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3 (- c0HPLETE FEE-~HEDULE BELOV
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATION OF INS'j/lQ...~
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~~ DESCRIPTI9..N.-... J ~
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JOB DESCRIP;LION
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Permits are non-traftsferable and expire
if work is not started wIthin 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
E1ectncal Contractor AIL~.^J Elf(1'1i1L
Address (~Su...)::\ ~ ~-t
City /Y\~S
Phone ~S" -.21J. q_
Supervisor License Number J OtJh ~
Expiration Date IO-I-ct.c;
Constr Contr. Number f..pg7L/~-
Expiration Date 9-'-/.-15'
,
,
Signature of SuperviSIng Electrician
.2?/K-- ^ 0P _;~,.~O~
Owners Name }4/:}./..';/.4v ~ ~c, D.
Address 7?9? I 5_ 3;;r:~i!I./ d
City s;::.~k Phone /~tI -bf~
OVNER INSTALLATION
The Installation IS beIng made on
property I own WhICh IS not Intended
for sale, lease or rent.
Owners SIgnature:
---------------------;-FT-A~-------
DATE: _ I) W :T""^LJ ~
RECEIPT 11:_ ~. IY 7 ~ '\
RECEIVED BY: J ~
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A. New Residential-SIngle or
MultI-FamIly per dwellIng unIt.
SerVIce Included:
It ems Cost Sum
1000 sq.ft. or less I $ 85.00 BS
Each addItIonal 500
sq. ft or portIon ?- ~O
thereof $ 15.00
Each Manuf'd Home or
Modular DwellIng
Service or Feeder $ 40.00
B. SerVIces or Feeders
Installatlon, AlteratIons
or RelocatIon:
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 SerVIces or Feeders
InstallatIon, Alteration or Relocation
.'
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
Branch CirCUIts
New, Alteration or ExtenSIon Per Panel
One CIrcuit
Each Addl tlonal
Circuit or with SerVIce
or Feeder PermIt
$ 35 00
$ 2.00
E.
MIscellaneous (SerVIce/feeder
-Each InstallatIon
Pump or lrrlgatlon
SIgn/OutlIne LIghtIng
LImIted Energy/Res
LImIted Energy/Comm
not Included)
s.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40 00
$ 20.00
$ 36.~
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