HomeMy WebLinkAboutPermit Electrical 1994-1-12
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225 FIFTH STREET 1\"1e \o\\OVI\~gd~~o noueqUl! -p ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 974~z~r;;~~~ ().
INSPECTION REQUEST: 726-'3769 . c .-0 illS-- City Job Number 4~/7e:9~
OFFICE: . 726-3759 Zonl<\.I--
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1. LOCATION OF INSTALLATION . ~"ur.
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LEGAL DESCRIPTION
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JOB DESCRIPTION -:-:> '
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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, j..lf-Ju.<.. /H,,,-
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Address ~') ~ .>
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Ci ty ..s:: P .(1)
Phone ")\,( 'I'll (,-..1-'
Supervisor License Number 3.:5 'Ff S
Expiration Date //-9S-
Cons t r Con tr. Number '8 'I' L/ 2. ~
Expiration Date 3-<"'-'1 '-/
Signature of Supervising Electrician
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;, Owners Name :!~ ~~~
Address
City Phone
01lNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Owners Signature:
DA~E~-----~~~~~-----------------
RECEIPT II: .//~'-I
RECEIVED BY: rL~
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COKP
E SCHEDULE BELOIl
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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
uni t.
Cost
Sum
$ 85.00
$ 15.00
$ 40,00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
D. Branch Circuits
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$ 40.00
$ 55.00
$ 80.00
see "B"
above
volts
Nev, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2,00
E. Hisce11aneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ~t? t:fI"'&'
5% State Surcharge /"2.. .'''''
TOTAL . V":? .-p
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