HomeMy WebLinkAboutPermit Electrical 1991-9-27
~,1~
~.
ELECTRICAL PERKIT APPLICATION
City Job Number C\ \\ \ l\l')
*
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION ,REQUEST: 726-3769
OFFICE: 726-3759
3.
COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
~O9, ~hJtn/\tfJ'Y'- J
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
A.
LEGAL DESCRIPTION
Sum
Items
Cost
$85.00
JOB DESCRIPTION
l,ULiv '~r }
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 B.
Electrical contractor~~ \:JrM,
Address P.O. &d, ,4gJ" ,
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
. Modular Dwelling
Service or'Feeder
$ 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
,
Ci t~fl1~' Q o.d, Phone
Supervisor License Number
'l4'-~1..31o
I(.,~t-, S
J() - J - q {)-J
03 gt.j.q
q -I-q ~
Expiration Date
Temporary Services or Feeders
'Installation, Alteration or Relocation
C.
Constr Contr. Number
Expiration Date
$ 40.00
$ 55.00
$ 80.00
see "B"
200 amps or less
201 amps to 400 amps
'Over 401 to 600 amps
"Over 600 amps or 1000 vol ts
Signature of Supervising Electrician
rf1)w~c 7~,
'" D.
Owners Name ~rlt ~ n.b1JmL ~
Address '102 ~
,City J~&~Dad ,Phone '1,^b-ObS~
OIINER INSTALLATION
above
-/
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00 3'5.00
One Ci,rcui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 2.00
The installation,is being made on
property I own which is not intended
for sale, lease or rent.
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
Owners Signature:
s 5'. DO
t. '1_~
?Jt-" '15
5. SUBTOTAL OF ABOVE '
5% State Surcharge'
TOTAL
~~~~~--7q=--'1"=- c\ \ ---
RECEIPTill: '~I L/t./"'~
,
RECEIVEq BY:' ~ \, --:2.J ------
'. I