HomeMy WebLinkAboutPermit Electrical 1994-8-18
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SPRINGFIELD
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,. . oee not require so< . ,.,:. '. "!l_
e, I' .. ,. "'ELECTRICAL PERMIT APPLICATION
225 FIFTH STREET
SPRINGFIELD, OREGON 97477 '"~ C-v
INSPECTION REQUEST: 726-3769 <?r lit /f.
OFFICE: 726-3759 Q~..,r
1, LOCATION OF INSTALLATION-~ ~igneture 0 ~
3/7'2 c:;~ /..;:l ~ A.
LEGAL DESCRIPTION
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q?'o~76
City Job Number
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling
Service Included:
uni t,
Cost
Sum
/'O? ej'/J"1)
Items
$ 85,00
1000 sq.ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
. JOB DESCRIPTION
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$ 15,00
Permits are non-transferable and expire
if work is not started ~ithin 180 days
of issuance or if,work is suspenaed for
180 days.
2. CONTRACTOR INSTALLATION ONLY
$ 40,00
Services or Feeders
Installation, Alterations
or Relocation:
B,
Electrical Contractor /.J..).v<{_N p;-....~~z....
$ 50,00
$ 60,00
$100,00
$130.00
$300.00
$ "0,00
,( t1 ill S' P .,.p C!. Co
Phone 1(P"Y"fJ~
/..( tfR
Supervisor License Number /2. R~I
/ /;/f?92
Constr Contr. Number J..(") -'5,7((, rff
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Signature of Supervising Electrician
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Owners Name~!,5 ~~W
200 amps or less
201 amps to "00 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Address
(C;l.{Q\Q...U.1l2-
Q
City
Expiration Date
Temporary Services or Feeders
Installation, Alteration or Relocation
C,
$ "0,00
$ 55,00
$ 80,00
see "B" above
200 amps or less
201 amps to 400 amps -----
Over "01 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Branch Circuits
D.
New, Alteration or Extension Per Panel
Address
$ 35,00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
City Phone
$ 2,00
OVNER INSTALLATION
E, Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ "0.00
Sign/Outline Lighting $ 40,00
Limited Energy/Res $ 20,00
Limited Energy/Comm y $ 36.00 ~-
5. SUBTOTAL OF ABOVE ~,_c-
5% State Surcharge I: f;?e>
3% Administrative Fee L. D 2l!.,
TOTAL -:?~ ~
The installation is being made on
property I own which is ,not intended
for sale, lease or rent.
Owners Signature:
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1L/3..r~.
~;'--l~----'
DATE:
RECEr'PT #:
RECEIVED BY: