HomeMy WebLinkAboutPermit Electrical 1997-3-28
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!~~.~ollo""ing. projN:t as c.ubmitted hos tho~J;j~~~ftFIE':"D
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225 FIFTII STREET
SPRINGFIELD, OREGON 97477 Authorized Signalure
INSPECTION REQUE'ST: 726-3769
OFFICE: 726-3759
3.
l~t~O~~N~~.
LEG D SCRIPTION ' TI
~OB DES~PTION & 111/1
1 -
Permit are non-transferable and expire
if work is not started 'within 180 days
of issuance or if,work is suspenaed for
180 days.
City Jooi'<umber
ELECTRICAL PERMIT APPLICATION
a.10\ lo~
LJM
COMPLETE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq.ft. or less ~ $ 85.00 !2D
Each additional 500
sq. ft or port ion 4- &:l
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
. NI,,c'\ ,\,' 1\ ^_ Installation, Alterations
Electrical Contractor...lU..J' ( (lrT0\c, &0 b'1J..: or Relocation:
Address ~Vl' J S-- P CY\ <;Or'\~ 0, t e~ 200 amps or less
N ) ~,20l amps to 400 amps
Ci ty <::. Ph on e..-.J ~ q -, ?> 6. b 401 amps to 600 amps
~ , 601 amps to 1000 amps
Supervisor License Number ~.::I3 - S Over 1000 amps/volts
If Reconnect Only
Expiration Date I qS-
Constr Contr. Numb~r ~D-3~~~
Expiration Date II/ q S'
Sito:.:~UP[)i~i~ian
owner~ Qj ~
Ad<lress_ igt7%- f'~& j
"" Phone 71J1' /523
City
The installation is being made on
property I own which is not intended
for sale, lease or rent.
.
Owners Signature:
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DATE: -=?-::2Sil-?7
RECEIl'T 11:. :z ~R 'Z
RECEIVED BY: /' -4.-4'~.J'_~ -
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$ 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
vo.lts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF AIlOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
S 36.00
, cO
&an,
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