HomeMy WebLinkAboutPermit Electrical 1997-2-3
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ELECTRICAL PERMIT APPLICATION
Ci ty Job Number 9'50 I '-1'-1
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
97477 Zonina -SLy:
726j:;P69 J .-<- ': 7
Authorlzod Signaturo N M
1. LOCATION OF INSTALLATION
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iGJ;7!Jl?1l/t!(? In I
COMPLETE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling
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 Dwelling
Service or Feeder
JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if work is suspended for
180 days,
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor,Sonitrol Security or Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
\
Add"ess P.O. Box 21009
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
Phone 461-5678
Ci ty Euuene
Supervisor License Number ..Jt,rxq RET
/tJ- 1- qq
Expiration Date
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
Cons tr Con tr. Number 65149
$ 40.00
$ 55.00
$ 80.00
see liB" above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date ;: .- g,o;. 7-2tJOO
Signature of Supervising Electrician
4l~4~ '
- -
Ovners Name 5h()rev.)orx! /6.cKO:ir::.:J
Address Samp
Branch Circuits
D.
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
747-9/)(jJ
Phone
City
$ 2.00
OVNER INSTALLATION
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm --L-- $ 36.00 ~
5. SUBTOTAL OF ABOVE 31.000
5% State Surcharge J 80
3% Administrative Fee ~ ol!:
TOTAL ~K13e
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent,
Ovners Signature:
----------r.z'r--t - ----------------
DATE: < /::<, Cjr .
RECEIPT ~:I./ .l.L/J...Il ~ ')
RECEIVED BY: ,~)Yl .ll-"'L