HomeMy WebLinkAboutPermit Electrical 1999-11-1
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ELECTRICAL PERMIT APPLICATION
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLAT,ION
3 , q 6 FiC-A~ fcf:^ tJ( u./
/7'15/]
Ci ty Job Number
3. COMPLETE FEE SCHEDULE BELO\!
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
. A.
LEGAL DESCRIPTION
/7/1? 34.f /
Sum
Items Cos t
C)C)~
'$ 85.00
1000 sq.ft. or,less
. Each add i t ional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
.' Service or Feeder
JOB DESCRIPTION
<;'t"r" A ,/f-y '>'1' r~
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 .B.
. Electrical contractor..flJ?T )t'c.Jdi:;/
AddressL~O ( .a.n.~1
$ 15.00
. $ 40.00
Services or Feeders
Installation, .Alterations
or Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Phone )'(2- 7 J ( 5
Supervisor License Number 1; c:: 3 \ L. ~
Expiration Date / d I ( / (5"L
Constr Contr. Number. c;- q "ic( -(
Ci ty tS=_--<
;
C. Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
'see "B" above
Expiration Date ~;':7~(
Signat~re of Supervising Electrician
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Owners Name Pc 1.1: r '. /\/,. ~/)'1./
Address.;l VI?, '" rrc/ ~o-A4oJ .
.
Ci ty J;</c;,,,, _< Phone..fK( '-...O'2...(Cf.
OVNER INSTALLATION
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
D.
. .
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or. Feeder Permit
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or i'rrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm --L- $ .36.00J~.';..!::..-'
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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-/ "'~
37.&J
5, SUBTOTAL OF ABOVE
7% State Surcharge'
3% Administrative Fee
TOTAL
----------------~~-~-----------------
DATE: !I/ / /5'5'
RECEIPT II: --z.p/-o .
RECEIVED BY: - . , .
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