HomeMy WebLinkAboutPermit Electrical 1997-6-5 (2)
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Authorized Signature
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION'REQUEST: 726-3769
OFFICE: 726-3759
1.
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\ LEG_~ QE~CRIPT~I\, '.
~t5.~A'Af) ( 1 J-\.\)lO
~JOB
01:\
Pe its ~re non-transfera Ie and expire
if work is not started wi thin 180 days
of issuance or if work is suspended for
180 days,
.2. CONTRACTOR INSTALLATION ONLY.' ". .B.
E1ect~ica1 Contractort11~ ~ fS~~
Addres~ CbL\- l\~2W\. ST'
Ci ty fu~ Phone.:s4+. -1I16q
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Supervisor LicE~ns~ Number 5'5'X>}i~
Expiration Date . '-JqCJB ' , '. 6.
Constr Contr, Number \ if\\Q\)<;'
E~piration Date' 'Q .l\.q~ .
Signat~..E. ree ~. " ,ssuu~ rvis~iCian.
. 7h/~ ./.~.
owner~ NamJ':fu.~ ""~~ ~ .,.
Ad~ress ~~\ t itl~lli'o tJ.(
Ci~y\ ~n~\r(\/ ~:Phon~
~~TION
A-
Ci ty .Job Number
._- .u...."c;nUCAL PERMIT APPLICATION
Ql[ynl
3.
COHPLETE FEE SCHEDULE BELOV
Items
uni t,
Cost
$ 85,06
$ 15.00
$ 40,00
. A.
New Residential-Single or
Hulti-Family per dwelling
Service Included:
$. 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.' Temporary'Services or Feeders
Installation, Alteration or Relocation
The installation is being maae on
property I own which -is not intended
for sale; lease or rent,
Owners Signature:
. DATE:
RECEIPT II:
RECEIVED BY: .
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~~~
1000 sq,ft, or less
Each additional 500
sq. ft or portion
thereof .
Each Hanuf'd Home. or
Modular. 'Dwelling
Service or Feeder.
. 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 .
200' amps' 'or less
201 amps to 400 amps
Over 401 to 600 a~ps
Over 600 amps or 1000
D.
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80,00
see "Bit abov~
.'
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline 'Lighting
Limited Energy/Res
Limi ted Energy/Comm .
. One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
E.
.5.
SUBTOTAL UF ABOVE
5% State' Surcharge
. 3% Administrative Fee
TOTAL
'$ 35.00
$ 2.00
no t included)'
$ 40.0'0
$ 40.00....J~
$ 20.00 .
$ 36.00
.1'~
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