HomeMy WebLinkAboutPermit Electrical 1996-12-18
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225 FIFTH STREET ' li1 ((J - ~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 D,\g_LC. .!) f1 I
INSPECTION REQUEST: 726-:t7.6ll>rizodSionatur. {(\, rn lJ~ ty Job Number '-"lrCe I yq D '
OFFICE: 726-3759 ~
3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
: J(p/? /....41,1 /?j)..
I LEGAL DESCRIljrN Q
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JOB DESCRIPTION
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fermits are non-transferable and expire
,if york is not started 'vi thin 180 days
of issuance or if,vork is suspenaed for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor6A~/U r::. ~~c..
lIddress/.2n Ui'l" I r1J)~
Ci ty h.u..8- lG_
Phone 2,'ltJ- -::>,C,ln/
Number .l..t2..q.,s
/1'1/4'1
;
Supervisor License
Expiration Date
Constr Contr. Number rl)~
Expiration Date ~,~?
Signature of Supervising Electrician
rf' I'./.; ..f..:/..;-;::
Ovners Name IAJ/LUI>.J..A J.A. <>,
Address -83..- W J 'fI't
Ci ty t7A ~Gf-)E Phonejo'i?io-<J7'-J..2..
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
~~~~.:r~~l~,~~~~~---------------
f;U'CEIVED BY!\ . m 0 <Ll..d 0
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
It ems Cos t
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
B.
Services or Feeders
Installation, Alterations
or Relocation:
,
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
5O,j)O
200 amps or less --L--
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see I.~B" above
, Nev, Alteration or Extension Per Panel
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res . $ 20.00
Limited Energy/Comm $ 36.00
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
."1'100
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