HomeMy WebLinkAboutPermit Electrical 1998-10-20
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225 FIFTH STREET ';'-Q/0~~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 974b? . ~~~
INSPECTION REQUEST: ~26~376g<'O"t "0, <?,o City Job Number 'i610 9 7
OFFICE: 726-3759 "''',,^,~ ""9~~ ~
.~~ 'i>I.:> ,''lo;3'~COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATIOtl-Q '~r "'<'t>~~r.
C;-J-'i7 s' Q4 L.-=o 7)fI (~~ A. %~~sidentia1-Sing1e or
, ' - M~":r~ mily per dwelling uni t.
LEGAL DESCRIPTION Servlce nc1uded:
/7o'L <'<: .~ J /')C;t!lO/ Items Cost Sum
JOB DESCRI~ION ~OOO sq.ft. or less $ 85.00
;7/~~ ~~~ Each additional 500
. q. ft or portion
Permi ts are non-transferable and expire thereof $ 15.00
if york is not started vi thin 180 days Each Manuf'd Home, or
of issuance or if york is suspended for Modular,'Dwelling
180 days. Service or Feeder .$ 40.00
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Ii
I
i
Address
Ci ty
Phone
i
;
i
Supervisor License Number
Expiration Date
B. 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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40,00
Constr Contr, Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising Electrician
Owners Name I ! f .uJ .h7Lh) r-
Address ~c, C:;<.,7',
Ci ty 1/; Ita.
U"~~~
Phone 9-,9h -0.'52 7
OIlNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent,
Ovners Signa~re~
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RECEIPT 11: 0 '< / ?>.+O .
RECEIVED BY: ' ;.//>r_-->
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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 trB" above
"
Nev, Alteration or Extension Per Panel
One Circuit
Each Addi tiona1
Circuit or vith Service
or Feeder Permit
$ 35,00
$ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
40 Ih?
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