HomeMy WebLinkAboutPermit Electrical 1998-12-2
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225 FIFTH STREET ~_2:?t$ equ' . ELECTRICAL PERIIIT APPLICATION
SPRINGFIELD OREGON 97 7'r"v'nUl op , Ires vC))/".Q... .
INSPECTION REQUEST: 1~Q~lWJion Center. ThOs~nr~/uregon LJtiitty Job Number l' r 10 I 7
OFFICE: 726-3759 JnOAR952"001-0010thro es are.:et forth . *'
0090. You may obta' ~gh CCG'il.o'.k.:<WJ"FEE SCHEDULE BELOll
1. LOCATION OF INSTALLA~ center '~c~PI.es of the rules by.. .
qe, '1 !::/z'(AS 41u th~ ".; 0 EA.!,heml(lpll~dential-Single or
enter/s-l iooon Utility 1M1l([ftdat!tltlnily per dwelling uni t.
LEGAL DESCRIPTION . -332'23M):vice Included: ..
/7D3 2~"1. 0 (JO~Or Items Cost
200 amps or less $ 50.00
201 amps to 400 amps $ 60,00
Phone ~b11t?,f17 401 amps to. 600 amps $100.00
~~; 601 amps to 1000 amps $130.00
Supervisor License Number ..:ifJI~-P;1=.P;"'T"HA Over 1000 amps/volts $300.00
AUTHOR ." LL EXflj.Flf<IP~R'EC Only $ 40.00
Expiration Date /o/If IZEDUNDEI=lT' WORK
vVMMFNCED C'. H1fifnli>Rr;a7t16 ~(;fvices or Feeders
Constr Conn, Number ]'7- 4.1B./:t-::.r;:., OR ISABMJ/!I,lj~fblat..ion, Alteration or Relocation
. . 'V'I WI r "'fRIOO. . r-Of1 ~
I" / t f' 200 amps"oT less I $ 40,00 Y (1"
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80,00
Over 600 amps or 1000 volts see "B" above
JOB DESCRIPTION
T~ 10>1./-----
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
Electrical Contractor.::z:NFI"'I"f"f G4=r,
Address..lcDt S-L-J ~ m '" <i'~ s~
Ci ty fbr-rI,q."vD
Expiration Date
Signature ~v~~trician
Owners ~ :5..,C- fl c,ro..:t
Address 3"16r'l:i4ldy VI/!:'- L._
City~tI~ (...JY Phone 7lf(,~ f'Nl{
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Ovners Signature:
D~TE~--------/~J1~l'ff-----------------
RECEIPT 11: 0;1) ::",:NI)
RECEIVED BY: A..(t "J,."J
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular'Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations
or Relocation:
D.
Branch Circuits
Sum
$ 85,00
$ 15,00
. $ 40.00
"
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
CircLlit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35,00
$
2.00
not included)
$ 40,00
$ 40.00
$ 20.00
$ 36.00
(It) 0 D_
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I. (7-.'"'
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