HomeMy WebLinkAboutPermit Electrical 1996-9-26
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". The ~oHov,ir.g pr~ject as ,ubrnrttod he:l the followi
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
974 N'thorlzoo Signature
726-3769
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ELECTRICAL PERMIT APPLICATION
City Job Number
qc:: /"2 '9 cr
. 3. COMPLETE FEE SCHEDULE' BELOY
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
2. CONTRACTOR INSTALLATION ONLY ,B. ' Services or Feeders
. . ' Installation, Alterations
Electrical Contractorf 4jfcTe(c./1-wOc<J"~...I,.4J,I Relocation: .
Addres's (f. D . Gn-,c .<HIQ $ 'Z. 200 amps or less
201 amps to'400 amps
401 amps' to. 600 amps
601 'amps to 1000 amps
Oyer 1000 amps/volts
Reconnect Only
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JOB ,DESCRIPTION
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Permits are non-transferable and expire
if vork is not started within lBO days
of issuance or if work is suspended for
180 days.
Ci ty ~'~J '-, Phone t, i'6 ~6d < J....
Supervisor License Number 3V9? C,
Expiration Date /1)-/::"'q'K
,Constr Contr. Number ')o;?t "I
Expiration Date /1.. -..) 7 - 'i' fa
Signature' of Supervising Electrician
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, ,ovner~ Name ,l?:,L../ rJu-r~
Address .'1 q?; 7 0!4,..:.L ~_ t:TJ
City
Phone
OYNER INSTALLATION
The installa t ion is being made on
property I own which is not intended
'for sale, lease or rent.
Owners Signature:
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DATE:, 9:.. '2S'~
RECEIPT jI: .:? :7"=2 :::> /" ' ,
RECEIVED BY: ....---~~-
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1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
---
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$ 50.00
$ 60.00
. $100.00
$130.00
$300.00
'$ 40,:00
C.
Temporary' Services or Feeders
Installati'on; Alteration or Relocation
200 amps' 'or less
201 amps to'400 amps
'Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch 'Circui ts
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
CIrcu'i t or 1.ii th Service
or Feeder Permit
$ 40.00
$ 55.00
$ 80.00
volts ~ee IIB'l above
$ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
, Limi ted Energy/Comm
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
,'$ 40;00
$.40.00
$,20.00
$ 36.00
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