HomeMy WebLinkAboutPermit Electrical 1992-7-15
T:':", foliowlrlg projecta. submlllodhll8lhe fonowlflt , ~,.,
225 FIFTH STREET ;,,'n;ng. and do.. not r.quira spaclfic lancBlmCTRIcAL PERMIT APPLICATIOlI
SPRINGFIELD, OREGON 97477 {Jpprovol. '.. q' Q/
INSPECTION REQUEST: 726-3769 Zoning ~ Ci ty Job Number ' ZO~~- D
OFFICE: 726-3759 ~ ,I~M~
Oat.~ 3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATIAlIIlI1oriz9d Signature !J~'
Lf 'h ?~ '-7 'Frnr'5v.,"-f1.v'f"7^.-- A. Ne~ Residen t ial-Single or
J' Multi-Family per dwelling unit.
kEGAL DES~PTION Service Included:
!'(oZ-DI?Z-/ O/7_D() Items Cost Sum
JOB DESCRIPTION
-+- .et'!iJ.D
',.
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
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
O~ners Name ~~ '5 - -IbuS?e-v
Address Lf ~ z:a ~'Ttt1c<-
Ci ty 'S})ft 01 Phone
OVNER INSTALLATION
The 'installation is being made on
property I o~n ~hich is not intended
ti:~71:~
------------,T--J-------~--------------
DATE: YJ-h -Cf~'
RECEIPT #: V:0.J ')f
RECEIVED BY: iJ~
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular D~elling
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
$ 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 or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
$ 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 Lightin~
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or ~ith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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