HomeMy WebLinkAboutPermit Electrical 2001-3-1
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ELECTRICAL PERMIT APPLICATION
City Job Number (!/ / - tJO/~7-nl
3. COMPLETE FEE SCHEDULE BELOV
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DEVELOPMENT SERVlC&l8g?lllllAMlllfll'l\llT1'equire speCific land use
approval
Zonin:
Date
225 FIFTH STREET Authorized Signature
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
/703 :22 -1-/ 02 'lt90
JOB DESCRIPTION
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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
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name K~~ u,'1b1-. '" >-"
U I
Address (d 6- k/', 'p (1":
City~&V..t Phone 7,.,1C,-?3<J.99(,q.)
O~ ~NSTALLATION 7.JC, -/0;1(.", (JI')
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~~~-~---------------
DATE: ~ --/=-#/
RECEIPT jI: 4)$ 5'
RECEIVED BY: .r"?"~,
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
200 amps Dr less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
$ 40.00
$ 55.00
$ 80.00
see liB" above
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit /0 $ 2.00 20.0'0
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting-----
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
no t included)
$
$
$
$
7DOO
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40.00
40.00
20.00
36.00
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,. TRANS#: 01-0004589
-, '-DATE:MAR 01 2001
AMT RECD:2 $ 77.00
CHANGE:
CASHIER:003
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