HomeMy WebLinkAboutPermit Electrical 1991-2-20
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SPR.~IELO
225 FIPTR STREET
,SPRINGFIELD, OREGON 97477
INSPECTION REQUEST:' 726-3769
OFFICE: 726-3759
ELECTRICAL PERKrr APPUCATION
Ci ty Job Number' q { 0 ( ()l
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JOB D~s..CRIP'{ION ' ,. ~"
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permit~' are non-:ransferable \J:d expire,
if work is not started within 180 days
of issuance or if work is, suspen~ed for,
180 days.
2. CONTRACTOR INSTALLATI!)N ONLY'
3. COMPLETE FEE SCIlEDULE' BELOV
A., New Res~dential-Single or '
Multi-Family per dwelling unit.' ,
"Service Included:, '.
Items Cost
, Sum.'
B.
1500 sq.ft. or less $ 85.00
Each additional 500
sq. ft 'or. portion
thereof ' $' 15.00
Each Manuf'd Home or
Modular Dwelling, IA , 'n(~'
Service 'or Feeder ,~. $ 35.00, ~ .}:
Services or Feeders (10 Branch Circuits'
, includ~d)~ Installation, Alter~tions '
or Reloca tion:
: '
Electrical Contractor.
Address
City
Phone
100'amps or less
101 amps to 400 ampsi
401 amps to 600 amps
, ,
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00
$' 60.00 ..
, $ 90. (,)0 " '
$130.00
$300.00'
$ 35.00
..'
Supervisor License Number
, Expiration Da'te
Constr Contr. Number
C. Temporary ServiceS or Feeders ,
Installation, Alteration or Relocation
~xpiration Date
'C
200 amps or less , $ 35.00
201 amps to 400 amps $,40.00,
Signature of Supervising Electrician Over 401 to' 600 amps $ 80.00
" ' Over 600 amps or'1000 vol ts see '''B'' , above
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Owners Name..! V\)\)) ~ \l.. ~'1 1\ \ )\ \ l\.LZ..) ~ ,
, :f\\A.-c2... ~ ::t.\<'~4=\c:(.... New; 'Alteratio~ or Extension Per Panel'
Address a. ":\~l..'f\ U\ (5': .....J\...V '.
~' (Nl '~l Ll.. -, ':)lo' .~ c::: One Circui t
Ci ty ,\ "- Phone 1" I-\~J ''-.,)--J Two to ten Circui ts
- \ , ' , ' Each Addt'l ten or
OWER IN5nLLATION', . '" portion thereof'
$ 35.00
$,.50.00
$ 15.00
The installation is being made on
property ,I own which is not intended
for salet-,. ~ease or rent. '
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RECEIPT I: -1-, _ ICI <~
RECEIVED ,BY: r ~ /) { /0/\ .
E. Miscellaneous (Service/feeder not included)
-Each installation'. '
Pump 'or irrigation
Sign/Outline Lighting'
" Sign~l Circuit or
limited energy panel
$ 36.00
$ 36.00 '
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5. SUBTOTAL OF ABOVE
5% State Surcharge,
, TOTAL
$ 36.00
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