HomeMy WebLinkAboutPermit Electrical 1996-1-11
ubmfrted ha. the lollowlnll
"The 1o\\O'Nlng prolect as Guire specific land ut-E'
zonir.g, and dc-as nct req
approval. , ....P R
225 FIFTH STREET ZOOlngf" ~_
SPRINGFIELD, OREGON 97477 \ -\\_,\ ~
INSPECTION REQUEST: ~~6 'l7!;9 - ~ Ci ~y Job Number ~... ~ ;; ...c:...
OFFICE: 726-3759 r\ edSlgnature. ...- *
Autho % 3. COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION
7'"37 ~4~ ~r. A. Nev Residential-Single or
Multi-Family per dvelling unit.
LEGAL DESCRIPTION Service Included:
J')-..::J,?~~C;;--7"'2. c::?:::3 ~~
, )'
.t'
'.
1
JOB DESCRIPTION
l~p~~Ji~Z,~~~,
~iis ~e~~ns erable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
E1ect~ica1 Cont~acto~ ~~~
Address
City
Phone
Supervisor License Number
Expiration Date
.
SPRINGFIELD
------ ,
ELECTRICAL PERMIT APPLICATION
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dvelling
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
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Tempo~a~y Se~vices or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name ,/. /~ D~
Address7b 7~7 ~~~_.
Ci ty.?7.~ .n&;zf. Phone~/'-:2~O-
~7 --; ~?er7?
OVNER INSTALLATION
The installation is being made on
property I ovn vhic is not intended
for s ,lease o~ : n t.
~
/llJA/Ii
---t-~------------~-----------------
DATE:, /___//r ~~
RECEIPT lI: 2~~~
RECEIVED BY: ~~~
200 amps' 'aT 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 "Bit above
Nev, Alteration or Extension Per Panel
,"
One Circuit / $ 35.00 ?,t;". dt::>
Each Additional
Circuit or vith Service 6t:?
or Feede~ Permit -I- $ 2.00 '2.
not included)
Miscellaneous' (Service/feeder
-Each installation
Pump or i~rigation
19n/Outline Lighting
Limited Energy/Res
Limited Ene~gy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Su~cha~ge
3% Administrative Fee
TOTAL
40.00
40.00
20.00
36.00
$
$
$
$
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