HomeMy WebLinkAboutPermit Electrical 1997-1-3
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SPRINGFIELD.... "
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225 .FIFTH STREET oale~ ~ ELEcmICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 A thorizodSi nature I< ,1M IIA
ruSPECTION REQUEST: 726-3769 . 9 ~'~y '-w Number %/Y5Y
OFFICE: 726-3759 .
1. LOCATION OF INSTALLATION
€:>4c;" 11111IN ~,
. LEGAL DESCRIPTION
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JOB DESCRIFTION
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permits are non-transferable and ex~i~e
if ....ork is not started' ....ithiri 180 da'ys
.of issuance or if york is suspended for
'180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical ContraCtor L.P, HtJtt'r/; 4r
Address 4"~ '5lte[(~ "1'(2.
Ci ty S ('ft? phone 7 117 -og II
, Supervisor License Number ;-t.a-olC.-.5
Expiration Date 11)-1- tf'k
Constr Contr. Number tJ( P3 ~
Expiration Da~e /,,-~-.'l7
siinatu~ of Supervising Eiectrician
'f Yf~ P"-r.fJ_-, ~
.~ !/ ..... 7.l.
~lImers N,\me ~ ......~~."a !:-".";U~C
Address ~ 1./.4". :A7~~
Ci ty . ,"5~L./J _' 'Phone'
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OIlNER rnSTALLATION
The installatioh.is being made on
'property I olin .Ilhich is not intended
for sale; 'lease or' rent. .
'Ovners Si~ture:
DATE: /7 -I"}'%
RECEIPT. ~: . . '=? ~d> ~'7' .
RECEIVED BY: ..-'lJ j,.-.;
'/Y
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3. COHPLETE FEE SCHEDULE BELOII
A. Nell Residential-Single or
Hulti-Family per dllelling unit.
Service Included:
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Hanufid Home or
Modular Dvelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation,' Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to ~oo amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40-.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to ADO amps $ 55.00
Over 401 to '600 amps $ 80.00
Over 600 amps.or lOOO.volts..see "B" above
D.. Branch Cirttiifs
Nev, Alteration or Extension Per Panel
One ci r~uii
.Each Additional
. Circuit or Ilith Service
or 'Feeder.pet'mi t
$ 35.00
$ 2.00
E.
Hiscellaneous (Service/feeder
-Each installation
Pump or. irrig~tioh'
sig~/cii.J tlineLigh t ing~
Limlted Energy/Res
. L'fm i ted . Energy: IComm
not included)
5..
SUBTOTAL oiABOVE
5~'State.Surcharge
.TOTAL . .
$40.00
$ 40.00 41'6
$20.00
$.36;00
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