HomeMy WebLinkAboutPermit Electrical 1991-8-21
SI"IINGt'IL:LU
225 FIITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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ELECTRICAL PERMIT APPLICATION
City Job Number 9/059J /
3.
COMPLETE FEE SCHEDULE DELOV
1.
LOCATION OF INSTALLATION
5105 .])~. ~~
LEGAL DESCRIPTION
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A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
JOB DESCRIPTION
O~S\&.~ ~
1000 sq.ft. or less
Each additional 500
sq. ft or portion
. thereof
Each 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.
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY
D. Services or Feeders
Installation, Alterations or
Relocation:
Electrical Contractor
Address
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
Supervisor License Number
Expiration Date
Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising Electr~cian
200 amps or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ BO.OO
Over 600 amps or 1000 volts see "B" above
D. Branch Circuits
New, Alteration or Extension Per Panel
O\Jners Name Ro~1c M<: ~8:Y
.
Address 5 \05 -=:b~ s.+
Ci ty~I\lL Phone 1/fCp-4CpJO
OVNER INSTALLATION
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One Circuit ~ $ 35.00 0
Each Additional .
Circuit or \Jith Service
or Feeder Permit $ 2.00
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
--------------------------------------- 5.
DATE: 7':7 - 2/ - 9/
RECEIPT i: -)4 \ / )1 14 .
RECEIVED BY: .1(YK~iF'U~ '-
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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