HomeMy WebLinkAboutPermit Electrical 1996-2-27
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zoning, and does not requlro spoclflc land use
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225 FIFTH STREET Authorized Signature .,a...,/) ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ~
INSPECTION REQUEST: 726-3769 City'Job Number Qc;.dC?("P
OFFICE: 726-3759
1.
3.
LOCATION OF INSTALLATIOE/ ?....../ ~ / A
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LEGAL DESCRIPTION...,I
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JOB Dr;SCRIPTION
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Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical' Contractor L ~ C E~)ck:,
Address 41o? JE'55t7.<t) M,
Ci ty ~,~ Phone ~q, - <(,c)~7
Supervisor License Number -f./ 74-5
/c)///5'S
Conser Contr. Number /(9 ",-.;r?',
Expiration Date
Expiration Date
.7-.JD-7'i:D
Signature of Supervising Electrician
LAurr:UfO ~' ~~ufloJ.\
O~ners Name pyur ~b,t?.r
Address
Ci ty Phone '7~& -/S-2. 1
OVNER INSTALLATION
The installation is being made on
property I o~n ~hich is not intended
for sale, lease or rent.
COMPLETE FEE SCHEDULE BELOY
Ne~ Residential-Single or
Multi-Family per d~elling unit.
Service Included:
!'tems Cost
Sum
1000 sq.ft. or less 2- $ 85.00 /70
Each additional 500
sq. ft or portion
thereof ...2.:.... ."$ 15.00 :5 '0
Each Manuf'd Home. or
Modular 'D~elling
Service or Feeder $ 40.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
S 80.00
see UBI! above
New, Alteration or Extension Per Panel
S 35.00
$ 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 $ 36.00
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
Ovners Signature:
~~~~~~--~---~-~~to----=-----
RECEIPT If: \ l'-I\",-' \ -.rJ.....\L\
RECEIVED BY: ~~ rI\l}l\
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
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