HomeMy WebLinkAboutPermit Electrical 1997-1-28
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[>,,~ :tll.:t.l-l. ./If/} I~CAL PERMIT APPLICATION
97477 ,\uthQrizOO Signature A /L-+t1 ~ '".- 0""-'7 ':2,
726-3769 I City Job Number ~ " (' )
3. COMPLETE FEE SCHEDULE BELOV
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF,-l;!'STALLl\TION
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LEGAL DESCRIPTION
ISO? 00/2.(/:JtbtJv
.,JOB DES~PTION
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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 \'
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name~~ ~~ &;d
Address '7>q q 7)n :<))\I1&(-S-f-
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City 1 Phone 7tfLI.;ffJ~(?
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OVNER I S LLATION
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
^ $ 40.00 t..fo. ()[)
$ 55.00
$ 80.00
see "Btt above
"
New, Alteration or Extension Per Panel
$ 35.00
$ 2.00
not included)
E. Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
C Owners ~e~ ---= Limi ted Energy/Res
~_~('" Limited Energy/Comm
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DA~E~--7~~-~=cr~-------------------- . 5~~~;~; ~~r~~~~~e
RECEIPT 1I:_:I~t//1 3% Administrative Fee
RECEIVED BY: Ci::: TOTAL
,B. Services or Feeders
Installation, Alterations
or Relocation:
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.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
The installation is being made on
property I own which is not intended
for sale, lease or rent.
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$
$
$
$
't{O. rJD
:2. /T?)
/..m
L(:{ :JJ)
40.00
40.00
20.00
36.00