HomeMy WebLinkAboutPermit Electrical 1998-4-15
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225 FIFTH STREET ~O~ Cll'\r-,I.I. E'J.?IP.E IrE~~AL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ?EP.t-/ll1v \'IIS?EP.~\ () Z/ 7 (J
INSPECTION REQUEST: 726_3769\-1IS oI2ED\l~DEP.1 "Do~\!D.'i'9P.Job Number 7 / A
OFFICE: 726-3759 r-,\l1\'10" IS r-,er-,\. '
t-/lt-/IE~CEOOP.3 COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INST~TION cO ~'1~EP.I()O,
3 n (j /&. J-01vV;ltJ;o'!3fJh"t' A. New Residential-Single or
- Multi-Family per dwelling unit.
LEGAf-, ~7'/j / 00/0/ Service Included: Items Cost
200 amps' 'or less
. - r 201 amps to 400 amps
Signature of Supervising Electrician Over 401 to 600 amps
~~ S- k4_ ,~ . Over 600. amp~ or 1000 vol ts
" , '?:~' 7 D. )lranch ClrCUl ts
Owners Name--Jj.'/J//"I ,J1vf1,~h ..f"l/?fl'IA?V/lrfi"Ji'~r/IC"'.,I . .
) J ,/ ,r New, Alteratlon or Extension Per Panel
Address~l'/ IJ } J-
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit
.~O:c ~~1~/tl1-/ f;~rJ,.~ A-jj,1;~/I
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 ,B.
Electrical contractor-MfJ- j./u~(CJ
Address 'f Irl- ilol#f11.-f f+ ' .
Ci ty e -,;"/1 (' Phone b! 6 ~ f JYy
Supervisor License Number,? Y'~J. (, 7-.{ Ie
)o/f/q,f
("') 7' Qq1. C.
Constr Contr. Number ~ ~ A
,~
/ ::J fl1 ..f
Expiration Date
Expiration Date
City
hone----1a.#l -L&Cf 0
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale. lease or rent.
~-n!~p~
-~-------------------"'--.-~-~----------
DATE: '-{/(t::;/q"
RECEIPT II:. .' [JJ..Ufl.fV2-
RECEIVED BY: ~ _
.;....
Sum
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
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations
or Reloca t ion:
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
Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
see "B"
above
$
2.00
E.
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm -----L- $ 36.00 .1C."U.:J .
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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