HomeMy WebLinkAboutPermit Electrical 1998-5-15
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
LQCATION OF .;r,NSTAI:Lf.TION ~ ';)
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LEGAL DESCRIPTION
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JOB DESCRIPTIQN A // /u'
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1.
Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days.
Constr Contr. Number
Address
City
Phone
OVNER INSTALLATION
The installation is being made on
property I OYn yhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE~-------S;~-/~~~-~-------------
RECEIPT 11: ,_ '\ .:J'1~ ~ I
RECEIVED BY: ~ I
-
ELECTRICAL PERMIT APPLICATION
97/~ I r
"',\ty Job Number
, '. - .'
~,~~.., 'g, "nd dOIl8 Il8 8U"-"-~ ......
~"rOVal. not ~'~-Iho
zon;~ land....,
Dat~ .<C:;-/$af/
Aut~ ....../0
97477 ~.JJ"1
726-3769
-
3. COMPLETE FEE SCHEDULE BELOV
. A.
Ney Residential-Single or
Multi-Family per dyelling unit.
Service Included:
1000 sq.ft. or less /
Each additional 500
f . I
sq. t or portlonAj'
thereof 1"''::2...
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~ ~~
- I
Address /1 II d..../~ JJ /I
Ci ty ~ ("k~ Phone C:~7 7 tf 2.
c:) t;~-'f
Supervisor License Number ,79JS
Expiration Date a>ci - '?I?
C. Temporary Services or Feeders
c; 7i!>ff.5' Installation, Alteration or Relocation
.. ''1VIICE'
Expiration Date C!?{'-!~" ~ =~' 200 amps"or less
, . " ~ I E:MIVIII SHALL E~Q;I,.,,a.!,,'ps to 400 amps
Signature of Supervising El~l:Jirt(i}ffiZEO UNO tl{jl!ll= ItOnH1HIV~~R amps
~~ ~M~EOORI:~:~~~~I1'~Wbrr 1000
. . RI~r;ro~y PERRi B't1meI'F~ff)fjJi ts
Oyners Name ' Q
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
Items
Cos t Sum
$ 85.00 .J/ '65".,..0
30,,0
$ 15.00
.$ 40.00
t
'f;
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
S 40.00
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
.'
Ney, Alteration or Extension Per Panel
$ 35.00 K
2.00~
One Circuit
Each Additional
Circuit or yith Servic~
or Feeder Permit ~ $
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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