HomeMy WebLinkAboutPermit Electrical 1997-6-5
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"The 10llcVling pro\eC\":~~ire .pecific lend usa
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225 FIFTH STREET 0<11 (Jl ,($''' '11 "f\/\
SPRINGFIELD, OREGON 9747], <,0<1 Signaiure_ Y'\
INSPECTION" REQUEST: 72~~3769 .'
OFFICE: 726-3759
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Permits are non-transferable and expire
if work is not started wi thin 180 days
of issuance or if work is suspended for
180 days,
1.
.2. CONTRACTOR INSTALLATION ONLY '. .B.
Electrical contractormA\f-hfl fS~.s .
Address ~O 4:Je~ Sf
Ci ty f]J~ ~A .1 ~. Phone ~l}d- - C:(Q. q
Supervisor License Number 55R"~q
..~qqB ' G
Expiration Date
Constr Contr. . Number-104\ ()\~
~. C\ .a."K
City Job Number
. . .
ELECTRICAL PERMIT APPLICATION ,
C\<\O~ q, f")
-
3. COMPLETE FEE SCHEDULE BELOV
Items
. A.
New Residential-Single or
.Multi-Family per dwelling unit.
Service Included:
D.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 'a~ps
Over 600 amps or. 1000
Branch Circuits
1000'sq,ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular'Dwelling
Service or Feeder
Services or Feeders
Installation, Altera~ions
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 .
$ 85.06
$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
Expiration Date
rVi~
Owners Na;'e\,1'{\i\Q{ 'S,.
Address-&QS\ I ~%-\{)~ \Jr\\~ /
CitY~PhOne .
. OIINER INSTALLATION
The installation is being made on E.
property I own which -is not intended
for sale, lease or rent,
Owners Signature:
______~__________~_____________________ . 5.
DATE: t; '5--"??
RECEIPT t: :z.~S--/
RECEIVED BY: . --:;;. ~
volts
$ 40.00
$ 55.00
$ 80.00
see ItB"
abov~
. New, Alteration or Extension Per Panel
"
. One Circui t '.$ 35.00
Each Additional .
Circuit or with Service
or Feeder Permit $ 2.00
not includ'ed)
Miscellaneous (Service/feeder
-Each installation
Pump or'irrigation
Sign/OiJtline 'Lighting \
Limited Energy/Res
Limi tedEnergy/Comm '.
SUBTOTAL 'OF ABOVE
5% State'. Surcharge
3% Administrative Fee
TOTAL
40.0'0
40,00
20.00
36.00
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$
$
$
$
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