HomeMy WebLinkAboutPermit Electrical 1994-5-9
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ELECTRICAL PERMIT APPLICATION
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 72GID37/iCl
OFFICE: 726-3759
Ci ty Job Number ~ Y~7'9
Authorized Signature JJ. ~ '';'MPIErIl FEE SCHEDULE BELOV
1.' LOCATION OF ~STALLATION '7'1....
~R </ IN'/Y?~Y/~eJ ~. A.
LEGAL DESCRIFTION
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, JOB DESCRImON " ~
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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.
New Residential-Single or
Multi~Family per dwelling unit.
Service Included:
Sum
Items Cost
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
Services or Feeders
Installation, Alterations
or Relocation:
B.
CONTRACTOR INSTALLATION ONLY
2.
Elect~ical ContractorYgt:A-.JiV}I;) C2~.../:
Address..$l6 S- brb7.l'~4~
"'-
City,C-~~ Phone y~~
, Supervisor Licen.se Number :2 S"~~
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
/~,,/'9':>"'
Constr Contr. Number 5'.8~
Expiration Date /...?~.9.5".
;;;:ltl:~ician
ers Nl\IIle, H~~1'ft .
. - -, -...
Expiration Date
Temporary Services or'Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$80.00
see "B"
200 amps or less
201 amps to 400 amps
Over 401 to '600 amps
Over 600 amp~.or 100u
D. Branch Circuits
above
volts
.~
New, Alteration or Extension Per Panel
, '
One Circuit' ........-- $ 35.00 3'~
,Each Additional '
. ,Circui.Cor W,',fth ser~jf . '..1r
or Feeder Permit , $ 2.00
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, .
E. Miscellaneous (Service/feeder not included)
-Each installation '
Puinp or, irrigation $ 40.00
Sign/,OiJtlin~Lighd.ng $ 40.00
Limi t,ed Energy'/Res , .$ 20.00
Linii ted Energy/Conim $36.60
Phone'
City
OVNER INSTALLATION
The installatioitis being made 'on
property.I own.which. is not intended
for side, 'lease or rent.
Ovn~~s Signature:
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''1'1.75'""'
5. SUBTotAL OF"ABOVE
,5%'State,Surcharge,
,TOTAL ',' '
. " . .' ~ , . . . ':."'.' ,:,". .'.
DATE: 5"...,- ~
RECEIPT. I: . ,/~<:'
RECEIVED' BY: ~:.. ..
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