HomeMy WebLinkAboutPermit Electrical 1991-7-2
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ELECTRICAL PERMIT APPLICATION
City Job Numb~r ,q ( DloK.3
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
,INSPECTION REQuEST: 726-3769
OFFICE: , '726-3759
1. WCA~~F~~()lP~:~
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~~;mits are non-transfer~ 'and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRAcrOR INSTALLATION ONLY B.
. Electrical contractorJt.A/~ If..t~
Address Rc"l,')- fA J/-clf D?c/ib. ,
, City +/?" Phone (' 3c/t/ -,llW
Supervisor License Number Q d.<J -8
Expiration Date'" /()/qj
COHPLETE FEE SCHEDULE BELOV.' *'
New Residential-Single or '.
. Hulti-Family per dwelling unit.., ..
Service, Included:. . . .
Items Cost Sum
1500 sq;ft. or less
Each additional 500
sq. ft or portion.
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
. $ 15.00.
$35.00. 2f)
r!J
Services or Feeders (10 Branch Circuits
included). Installation, Alterations.
or. Relocation:
$35.00
$ 60.00
$ 90.00 .
$130.00
$300.00
$ 35.00
100 amps or less
101 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
.Constr Contr. Number dO--;::))?() (l
. . - '
Jf) /q /
. Expiration Date'
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Signature.of Supervising. Electrician
.'...,~y,.~-".
...:::57ff~~
. Ci ty 'r1 )~O ,Pho~e
. OWNER IJJ.ALLATION
D. Branch Circuits
New, Alteration or Extension Per Panel
. One Circui t .
~TWO ,to ten Circuits
Each Addt'l ten or
portion thereof
$ 35.00
$ 50.00
$ 15.00
. The installation is being, made on
property, I ,own which is not,intended
: .'for' sale, lease or rent,'
E; Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation,
Sign/Outline Lighting
, Signal Circui t or
limited energy panel
$ 36.00
$ 36.00 '
Owners Signature:.
$ 36.00
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7T3, ~U
, ,-
,DATE: '/ .~ J::t J ___
. k,"".Ln.: . i-'/l(;-.).tt/A.J
RECEIVED BY: .
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
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