HomeMy WebLinkAboutPermit Electrical 1997-10-10
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Authonzed Signature __ n r'\ ,-I?' P.J q," .".<$>
225 FIFTH "uu,"r.r . ~ "'\~ C'"
SPRINGFIELD, OREGON 974Tk,' r:'':;-Yl fv~ '!t''V
INSPECTION REQUEST: ~~~:'3~6<) > -:::,,,{) '2; "r'<)
OFFICE: 726-3759 ~,(). ~~<" <co\) ~" ~.
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1. LOCATION OF INSTABtA'l;kO'N iif..v0 :A q,<<;
E;//3;L ~_5'.(~/-';1>'#' (\"r
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LEGAL DESCRIPTION #
ELECTRICAL PERMIT APPLICATION
City Job Number 9 -j / Is7
COMPLETE FEE SCHEDULE BELOY
Ne~ Residential-Single or
Multi-Family per dvelling unit.
Service Included:
. A.
Items Cost Sum
1000 sq. ft. or less ) $ 85.00
Each addi tional 500
sq. ft or portion J
thereof $ 15.00
Each 'Hanuf'd Home. or
Modular,Dvelling 40.00
Service or Feeder $
JOB DESCRIPTION /J /
/I /UA/ /Jut/.<:' C /Co RY~"/.A / " yG
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Permits are non-transfera~le ,and expire
if ~ork is not started ~ithin 180 days
. of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY .a'.
Services or Feeders, ,
Installation, Alterations
or Relocation:
Electrical contractorJll~~~~i~
Address PD. Gc'l, 1;;13.;l?,
Ci ty 5o.l.t. V'n Phone frl-,,-/)f!li-!.j8'1,Q
Supervisor License Number 2:<,;(,::; -;<1,_
Expiration Date j()-I -qg
Constr Contr. Number n9;oSQ3
$ 50.00
$ 60.00
$100.00
$130.00
$300,00
$ 40.00
200 amps or less
201 amps to 400 amps
1,01 amps to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
see,_ "B" above
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200 amps' 'or less,
201 amps to 400 amps
Over 401 to 600 amps
'Over 600 'amps or 1000 volts
Branch Circuits
Expiration Date
Signature of Supervising Electrician
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D.
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Owners Name~h"l \'(Ho\'V\h~ ~
Address \ F>o. ~. (6c;fic. Au.llA / Pf), ?,15/( LiSl
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Ci ty yY)omY1/J1~ Phone ,&;~-R~<6-00CjIo
OVNER INSTALLATION
New, Alteration or Extension Per Panel
$ 35.00
One Ci rcui t
Each Add it ional
Circuit or ~ith Service
or Feeder Per.mi t
$ 2.00
not included)
E. Hiscellaneous (Service/feeder
-Each installation
. Pump or irrigation'
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
The'installation is being made on
property I own ~hich is not intended
for sale, lease or rent.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
Ovners Signature:
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/og;od
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAl.
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DATE:
RECEIPT II:
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