HomeMy WebLinkAboutPermit Electrical 1999-11-9
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SP.FIEL'D
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. L.9CATION OF IN~,!~LATION
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, JOB DEJiCRIPTION
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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.
ELECTRICAL PERMIT APPLICATION
City Job Number qtl ~ 1 0
3.
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Ccst Sum
1000 SQ. ft. or less 2 $ 8~.00 /70
Each additional 500
SQ. ft or portion 2-
thereof $ 1S.00 30
Each Manuf'd Home. or
Modular'Dwelling j
Service or Feeder $ 40.00
C.
200 amps' 'OT less
201 amps to 400 amps }
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
2. CONTRACTOR INSTALLAT:ON ONLY ,B. Services or Feeders
\ k~\ Installation, Alterations
Electrical Contractor (I,ilil1()n E.' ,1~O'i Relocation:
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Address ~ 0 aOl( 420llJ 'Ni\1.~ 200 amps or less V $ 50.00
, 201 amps to 400 amps V $ 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
Cityeu~ Phone <}'&I 2-SQQ
'V
Supervi.sor License Number 455<, :\
Expiration Date /0/' / () I
I .
Constr Contr. Number "ZO~ 11?-.C-
Expiration Date
/()!t 1m
, I
, Si~~ture of Supervising Electrician
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- - -' -
Owners Name M rc t.u--<,t:-- /-.1 r'1'l7'7--
'Address 1/.'0 h' cr '>( 0.2......
City Vi c(t;{ Phone r7{~ )7C(7
OVNER INSTALLATION
, The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-
DATE~---~/I-~zr~~~--~--------------
RECEIPT I!' /l:'J Gr:/I ~ 7
RECEIVED BY: '1h -VIA ./1/\
.~ "
:~
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Temporary Services or Feeders
Installation, Alteration or Relocation
~
$ 40.00
$ 55.00
$ 80.00
see; IfB" above
.'
New, Alteration or Extension Per Panel
) .
One Circuit
Each Additional
Circuit or with Service
or Feeder 'Permi t
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited' Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
~ State Surcharge
3% Administrative Fee
TOTAL
$ 3~j.00
. .,1,
$ ~~.OO
nut included)
$ 40.00
,$ 4'\).00
$20.00
$ 36.00
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