HomeMy WebLinkAboutPermit Electrical 1993-7-26
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SPRINGFIELD
, ' ,,!'Ile,following project as submH.t{lo has the fol!o
zonmg, ang does not require specific land use '
225 FIFTH STREET approval. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zl'i>nina' , I/f)(2/.
INSPECTION REQUEST: 726-3769 <1 __~ 11_ Q~' ,'" f' .ci'~yJob Number"q ~<:!!J "7 .:> B
OFFICE: 726-3759 ' , D~te (." ~ -t../
, ' ALithorized Sianature ~ . COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION o-,..e /J. , "
7~5If!l """-pR~L C'~h.Y. A. New Residential-Single or
,', 'Multi-Family p'er dwelling uni t.
, LEGAL DESCRIPTION Service InCluded:
l7"'b~'2.41-~ ~'2BcC>~ Items Cost Sum
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JOB DESCRIPTION, ~ ~
.w::~ /~'"J- , , ..
1000 sq.ft. or less
Each additional 500
sq. f~ or portion
thereof, . ,
Eath'Manuf'd Home or
Modular Dwelling . .
Service or Feeder
$ 85.00
Permits are non-transferable and expire
if work is not started within 180 days
'of issuance or if work is suspended for
180 days.
I
.
$ 15.00
$ 40.00
. 2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~-~
~ . -.
B. Services ~rFeeders
Installation,' Alterations
or Relocation:
City
Phone
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
Address
Supervisor License Number
Expiration Date
Constr Contr. Number
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C. Temporary Services or'Feeders
Installation, Alteration or Relocation
.. ;":
..-
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Signa~ure of Supervising Electrician
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
Expi'ration Date
Owners Name ~ /~~~
Addres~ ' :~~~b
, /~/r',
City5~ LfP:? Phone 7~-Yv~'$"
OVNER INSTALLATION
D. Branch Circuits
'New, Alteration or Extension Per Panel
One eircuit
Each Additional
Circuit or with Service
or Feeder Permi t t:--- $
--- $ 35.00
-.
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-
2.00
"2'. ~
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The installation is beirtg made on
property I own which is not intended
for sale, lease or rent.
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E.
Miscellaneous (Service/feeder
-Each installation
. Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
~' ~, .
. 1- '
DATE~--------~ -~~~:3 -~--~--------
RECEIPT, .: ' 9~ 9"~
RECEIVED BY: ~~-
SUBTOTAL OF ABOVE
5% State Surcharge
" TOTAL
$
$
$
$
.~~
- I. g.,- '
~ ~
- -~-
40.00
40.00
20.00
36.00
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