HomeMy WebLinkAboutPermit Electrical 1998-10-20
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225 FIFTH STREET 0.. ~>O/)/~f'eqll/~",,:::~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 971t,7.7'~'.:J:< 1'2- "'c",'~,OQ"... '
INSPECTION REQUEST:' 7 Ttf!PNiiIJ.,,;:~.:..:t OS /)r:J '-"€l'f)il Job Number / % / I'? G)'fB
OFFICE: 726-3759 S~/) '*
Ili("..,...../I I 3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION <':::'<J~
<;"2ft,; f '7"b /.h?~ 57: Ne'" Residential-Single or
ti-Fami1y per d",e11ing unit.
LEGAL DESCRIPTION ~ Serv Included:
) 7/?? ''2. Z < I 65~ Items Cost Sum
JOB DESCRIPTION
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Permits are non-transferable and expire
if ",ark is not started ",ithin 180 days
of issuance or if ",ark is suspended for
180 days,
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
Ci ty
Phone
Supervisor License Number
Expiration Date
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular, 'D",elling
Service or Feeder
,B. Services or Feeders
Installation, Alterations
or Reloca t ion:
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
$ 85.00
$ 15,00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
Expiration Date
Signature of Supe~vising Electrician
. I
O",ners Name L1 f \;./ I? /'KJ iL
Address_405'.')~ C~~7"'.dC A.
Ci ty J//i),,;- Phone 0'76>~327
OVNER INSTALLATION
The installation is being made on
property I o",n ",hich is not intended
for sale, lease or rent.
Owners Signature: ~ I
;( ~ J~ 'S,,- ~ l 'Ji-J1----.
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RECEIPT 11: "(' 1'....# (
RECEIVED 8Y: -, .Jr"..,::::r---1
200 amps' 'OT less 1""'--
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
$ 40,00 .../JI <(J-e
$ 55.00 r
$ 80,00
see "B" above
"
Ne"" Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or ",ith Service
or Feeder Permit
E.
5,
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40,00
$ 40.00
$ 20.00
$ 36.00
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