HomeMy WebLinkAboutPermit Electrical 1996-10-10
.
Cd" lOr /o~ 7ft
9i'4'ti'riZed Signature 'jJ M
726-3769
ELECTRICAL PERMIT APPLICATION
City Job Number q & /37 OJ
..
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
COMPLETE FEE SCHEDULE BELOY
3.
LOCATION OF INS ALLATION
. .,tio bq.o.-/. 2, ,
LEGAL DESCRIPTION' jJl'\).~
"I 703~5<-12(){"qcnl
Ne~ Residential-Single' or
Multi-Family per d~elling
Service Included:'
A.
uni t.
Sum
Cost
Items
$ 85.00
'1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'D~elling
Service or Feeder
. JO~ DESCRIrrION-
-\fl\titp~Q~L\'I\..I\"t~~ Tr.1 (l0c6h,J
~ ~n~n-transferable and expire'
if ~ork is not started within 180 days
o'f issuance or if work is suspe-ndedfor
180 days.
I'
$ 15.00
I
!
$40.00
.Services .or Feeders
Installation, Alterations
or Relocation:
2. CONTRACTOR INSTALLATION ONLY ,B.
Ele.ctrical cont~actor(f~~f:DO(\t,{lf\ 'i~'
Address~. ILl-Z1-.J ,
Cit~C)W~ Phone '1t+I-j1.~b..
. ()\}
Supervisor LIcense Number ~hS
Expiration Date 10 -I-q 2
Constr Contr. Number ()'324Q
Expiration Date q"-I -qrJ
S 50.00 5"0,00
$60.00
$100.00
$130.00
. $300.00
$40.00
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
,
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
200 amps'. 'or less $ 40.00
201 amps to 400 amps '$ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 100v volts see "B'" a~
Signature of Supervising Electrician
aA....~q ~~. D
Owner~ Name.IC.l.Q.n h~O\.;(.' ~ tOniL. .
Address~i\-.' 7J .
Ci ty p~ l ~o \ . Pho'ne!liA :-:3"D 0 lo
OVNER INSTALLATION
Branch Circuits'
.'
New, 'Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or ~ith Service
. or Feeder'Permi t
$ 2.00
E. Miscellaneous (Service/feeder not included),
-Each initallation .
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
. Limi ted Energy/Res . $ 20.00
Limited Energy/Comm S 36.00
The'installat'ion is being made'on
property I o~n which is not'intended
for sale, leas~ or rent.
Ovners Signature:
50.00
1. =io
,j._'i"n
.&j: On
5. SUBTOTAL OF ABOVE
5% State Surcharge
.3% Administrative Fee
TOTAL
------------------Zf~----------~---~--
DATE: IfJ -/0 _vlp " , .
RECEIPT 1I: 2~tI<;?,
RECEIVED BY: tV;