HomeMy WebLinkAboutPermit Electrical 1997-12-3
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"i'1I. Q% ~~ ';~~:I' ELECTRICAL PERMIT APPLICATION
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"6'00 0-0 &1-0.... (~~ City Job Number Or 7 I ~ cr (e(
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'o~/,l 3:r-1, ~wo;~ FEE SCHEDULE BELOII
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. 'A. N't% R~dfIiMal-Single or
Mul~F{~t~~r dwelling unit.
Servi~li{l(jl)lded :
~ Items Cost
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Authorlzod Signature n YI\J
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
LOCATION OF INSTALj;ION
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LEGAL DESCRIPTION ~( 0 0 t!J
1703/~3'3, ()..-/.Q
1.
JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor Llffi ~/L.
Address ,"0_
City ~./b,
fllYJ
Phone ,/7.. "'/ -c;qi? J
'3 S 5' 35
10 - "U
Cons tr Con tr. Number --z. [} /:2-8-&-C/
Expiration Date ~ 5 -4 g
Supervisor License Number
Expiration Date
Signature of Supervising Electrician
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Owners Name lA S Cu u y--
Address
City Phone
OIINER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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DATE: 3;;iD nq_M ~ A c; 7
RECEIPT ':, ' ~l,{ I'SGJ
RECEIVED BY: ~ ,) ,
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
,B.
Services or Feeders
Installation, Alterations
or Relocation:
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c;o'!3-
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
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 100U volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
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New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40,00
Sign/Outline Lightin~ $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE $f: 60, -
5% State Surcharge .~ ~,Sl'
3% Adminis tra ti ve Fee '$ /. s-z>
TOTAL 19.h d, -
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