HomeMy WebLinkAboutPermit Electrical 1997-9-19
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225 FIFTH STREET NOTICE: ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 -91S "ERMIT SHALL EXPIRE IFTHE WORK fA t/-o-o
~~~~~~ro~2~~~~T: 726-376.!ITI~)P!lEDUNDERTHISPERMfMS)f.ld1'b Number 17/ *
' . ,_ '-"0 I\RIs3!l.6A~9~IW~EE SCHEDULE BELOV
1. LOCATION OF INSTALLATIONl)": .:I'.l.... \., .
.")';/6 JrJaJ./1....'7I: "fohoj_,,~:','r,,\' PSR\(iJ. New Residential-Single or
zoning, nndd~~~I~~; ~s &UbnMu.J.4t~i."fetpJ;!Y,inP'er dTJelling uni t.
LEGAL DESCRIFTro~ approval. " &qulro SetvH:ed In,cluaed: '
Ito,?2,C:;31 - I" :"";'"d .(!..( / Items Cost Sum
JOB DESCRIFTION , 0,t.q'I1::..'1..7__ lOU0' sq.ft. or less $ 85.00
fJromdft &..o.!..r-I-hL,..:......;".~Mure' Yl Each afdditional.500
, "I' ....-, C/-I-,W] sq. t or portIon
Permits are non-transferable and expire tnereu~ $ 15.00
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Son i t ro I Secu r i ty or Relocation:
Address P.O. Box 21009
Ci ty Euuene
Phone 461-5678
Supervisor License Number I ?:?9 /fEr
Expiration Date
/()-/- qq
Constr Contr. Number 65149
-
Expiration Date 7-2000
Signature of Supervising Electrician
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Owners Name L::;h-f:' fJ1fAs,r fJflkr:..
Address ~I fl7a/n ..sJ
Ci ty Sf]!' iJfl-e/d Phone 74C;-38d.;;2.
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
ror sale. lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT #:
RECEIVED BY:
Cf-ICj-Q7
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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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. 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
,$ 35.00
$ 2 .00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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