HomeMy WebLinkAboutPermit Electrical 2001-8-18
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SPRINOFIBLD
zoning. and does not require specific land use
approval.. r c....
225 FIFTH STREET ZOning I J:.,"","~LU"AL PERMIT APPLICATION
SPRINGFIELD, OREGON 97~le Wi 01 . ,
INSPECTION REQUEST: n~illJ,7;~ Signalure t::{,uUti-- City Job Number or- 00 <637. 0' <; () 2-
OFFICE: 726-3759 ~_. *1
3. COMPLETE FEE SCHEDULE BELOll
1, LOCATION OF INSTAL~T q
Cf&:> rl'11~p /,"'rv..l.- rY.. 71./77 A. New Residential-Single or
~ Multi-Family per dwelling unit,
LEGAL DESCRIPTION Service Included:
\,.()7,,22'7.n,OOC;t::l. Items Cost Sum
$ 85,00
1000 sq,ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Servi'ce or Feeder
JOB QE~;~f~~ .
0()'{)(l<'i ' (';..1(111 I /- l
.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. CONTRACfOR INSTALLATION ONLY B.
Electrical contractor~~-().J~S
AddressJDLO, Su1..f(J M
Ci ty _~J..~...rt . Phone U~ -z.\]'{)
Supervisor License Number 2Pt /.:S J~
Expiration Date IO}fJ!
Constr Contr. Number~()-I{~()~
Expiration Date lolnl
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
$ 50.00
$ 60,00
$100.00
$130,00
$300,00
$ 40.00
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
Temporary Services or'Feeders
Installation, Alteration or Relocation
C.
$ 40,00
$ 55,00
$ 80,00
see "B" above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
S~~~vlsuperv:v+;yan .
Owners Nam~ ~id.., W. (.JJ 1.)~ _
Address C1<i'<l, K' Y1L'\e _ (A.~
City~C\ri phoney(,,' 0Iik..
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OVNER INSTALLATION
Branch Circuits
D.
New, Alteration or Extension Per Panel
$ 35,00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
'$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40,00
Sign/Outline Lighting Z. $ 40.00 ~
Limited Energy/Res $ 20,00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 1)D. -
1% State Surcharge ~ '(fl)
3% Administrative Fee '2" 4'0
TOTAL c;c. 'h .
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
---------------------------------------
DATE:
RECEIPT #:
RECEIVED BY: