HomeMy WebLinkAboutPermit Electrical 1995-3-23
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225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769 City Job Number
OFFICE: 726-3759 ( ~
1. A rp~gION ~ lNSTALLA!ION
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LEGAL DESCRIFTION
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_~ JOB DESCRlPTION
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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 contract~~ \A.g,{'~ <(10,,1-
AddreSSm '9'1\ ~ffi\.~
City<c.. 'Y~I\O Phone~<6.CA~a
. Supervisor icelise Number .ff\C') (")~
Expiration Date 'l~, \.~:=1
Constr Contr. Number_C'f\2....C;..J 0
Expiration Date \ ~ . \0 .CJf\.
Signature of Supervising Electrician
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Owners NameJ'<\o.JtJq ,--,\~u~
Address ~()l 0 ~cJ. N\l 0......
City we Q lJ\.Q "' Phone
OVNER It~TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners' Signature:
------------------;.:--------------------
DATE: Z/J. ), /, [
RECEIPT j1: -. //.,'2/;J..
RECEIVED B'y: ~ /"'7;;.A..
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq.ft. or less $ 85.00.
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
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
$ 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
$ 40.00
$ 55.00
$ 80.00
see "B" above
Branch Ci rcuits
.'
New, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00 65
$ 2.00 d..
E. .
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
?-l\ .ci)
I.~
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40.00
40.00
20.00
36.00