HomeMy WebLinkAboutPermit Electrical 1999-4-21
225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769 Ci ty Job Number QJ? -/ e '6~'
OFFICE: 726-3759
3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION
7t1t) r~t'"""vA.'/'~".uA' Oh(l..... A. New Residential-Single or
~ Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
!t{)2., IS~oa2{l.n .. wrequiresyouto Items Cost Sum
ATTEN~II{JN:UI"YV" ",.. Irty
JOB DESCRIPTION follow rules adopted by the ~reg.T If~ ft. or less $ 85.00
SA~ &~./. sc:.Itll:*i1ICClti~enter.Thoserue~::f!l ~ditional 500
. OAR952-o01-0U1Uulro~gh StJle~15 or portion
Permits are non-tran~q.!Ja~1l9~1.1tQ!)Plesofthi~/i,0~ . $ 15.00
if work is not start~lkIi\f{he1.tl!htda)(~ote:.t~ete~ on ilnuf'd Home:or
of issuance or if worknoihtltHflMlIll(liregoo Utility No II. arDwelling
180 days.' Center is 1-800-332-2344)SerVlce or Feeder . $ 40.00
2. CONTRACTOR INSTALLATION ONLY .B.
Electrical ContractorC//'.., I//Cu.J E/.cJ.
AddressP tJ. ./!Sax ?oc:l7'J
City EIAJ9~ Phone.6tf'7'!c 7 ~
/
Supervisor License Number ~/ ~~~
Expiration Date / /J - 0/. ~ /
. ,
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
$ 50.00 ~O
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number..::? ~ . //0 c:...
Expiration Date / tJ . /.. 97'
Signature of Supervising Electrician
R~J CV2.h\ .......>~-:L J
- · C/ D
Owners ffm~hl'?I--' ~~+h..- .
Add~fsV 0 & X leo 0 ).-
Cit}( i\V-r/ N\" r"-- Pho'e~ 3?Jf.j / - t1 ef5
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale , lease or rent.
Owners Signature:
~ATE~;97-'::~-~---------------------
RECEIPT #05s::::.lS) ,
RECEIVED BY: n . I na.-~
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
$ 40.00
$ 40.00
$ 20.00
$ 36.00
. ,~() . c5D
-rl.-::;,u
I-Ad
,~q. . n I )
I
One ,'::ircui t
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited 'Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)