HomeMy WebLinkAboutPermit Electrical 1991-2-27
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i
ELECTRICAL PERKIT APPLICATION .
".
225 r~r.u ~.A46.
SPRINGFIELD, OREGON 97477
. INSPECrION REQUEST: .726-3769.
OFFICE: .726-3759
City Job Number .' 9/~)/)0().
3. COMPLETE FEE SCHEDULE BELOV
"1. LOCATION OF INSTALLATION.
,~77.~ WA~4~ "&fi.
LEGAL DESCRIPTION
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A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
, " JOB DESCRIPTION
~~ ~~/77t')A)
1500 sq;ft. or less
Each additional 500
sq. ft or portion
thereof
Each "Manuf'd Home or
Modular Dwelling
Service or Feeder
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
Items. Cost
Sum
$85.00' .
$ 15.00 . .
$ 35.00 '
Electrical Contractor" "
B. Services or Feeders (10 Branch"Circuits
included). Installation, Alterations
or Relocation:
"Address
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601'amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
City
"Phone"
Supervisor License Number
Expiration Date
$ 35.00 .
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
" Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
.Expiration Date
Signature of Supervising Elec trician
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps"
Over 600 amps or 1000 volts
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, Owners Name I<IJtP 1<( il '
Address . gq / D RJ( Ji /tl/YId.
City {;71!tl: Phone 1UJ., not!
,;
D.
Branch Circuits
$ 35.00
$ 40.00
$ 80.00
see liB" above
New, Alteration or Extension Per Panel
One Circuit
"Two "to ten Circuits
Each Addt'l ten or
portion thereof
. OVNER INSTALLATION
The "installation is being" made on
property" I.own which is not intended
" for sale, lease or rent.
i/' $ 35.00 .3.5fi'
$ 50.00
$15.06
E~ Miscellaneous (Service/feeder not included)
-Each "installation
Pump or irrigation. $ 36.00
Sign/Outline Lighting $. 36.00
. Signal Circuit or
limited energy" panel $ 36.00.
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, /~ATE:-Ei;." J:1, '011
, RECEIPT t:--.lJ':jIf.D
RECEIVED BY: WJlCVJIlA-'
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
+ 13 WC9,.o ,;O~7Z1"
~$.ao
/,75
,,<,..~.7S
+ -,E 0(;'. ~