HomeMy WebLinkAboutPermit Electrical 1997-9-29
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97477 Authorized Signature If\ "'^
726-3769 .' '\
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
Jh,
LEGAL DE~!.'..TION
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JOB DESCRIPTION
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 INSTALLATI~N 0 Y , .B.
Electrical contractotj~n t-\n1tf.}./
Address ,)41(') \}0. \ \'\V\ '" J\ 0 tlWJ
.. Ci ty (1 ~.lQ11 0 ....Phone 1114 .l03[ ofJ)
supe~nse Number tcr1r1~\~
Expiration Date If), \, Gq
Constr Contr. Numb~~ to35.'l1
\.'L'l-.Q1
Expiration Date
.Signature of Supervising Electrician
Owners Name \r\~f)UMQ
"d~~'() \ J'i\I\iu\ ~Jd
Ci t rL Phone141,q M 7
o STALLATION
The installation is being made on.
.property I own which is not intended
for sale, lease or rent,
Owners Signature:
. DATE: . " '7~~?::> .
RECEIPTJ!:. 2?~/
. RECEIVED' BY: :::? ~~ ~ c .
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ELECTRICAL PERMIT APPLICATION
Ci tv ;~b Nwnber~3-' l2
3.
COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion.
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
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
Reconn,ec t Only'
C.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40,00
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 "B" above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting~
Limi ted Energy/Res .
Limited Energy/Comm
5. . SUBTOTAL OF ABOVE
.5% State Surcharge.
3% Administrative Fee
TOTAL .. ...... '
$ 35.00
$ 2.00
no t included)
$
$
$
$
....,....4]~... '.
"'~JtJ.
40.00
40.00
20.00
36.00
w.I:Y