HomeMy WebLinkAboutPermit Electrical 1995-3-9
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'ihefollowln r' '. '..'-,,: .',- ~.;:,i!l.>
:!oning, and ~be~J~~ ~s su.bmmed,',las tho followinG .' ~)" ,.
approval. equrre Specl"C Ja'EI;ECTRICAL PERMIT APPLICATION
<.on'ng (~U ~ t""'C"\ 3- J
?_q$ City Job Number 7...) U u"'"
'1J M.HPLETE PEE SCHEDULE BELOII
225 r4r.n STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3783-
OFFICE: 726-3759 e
Authorized Signature
LOCATION OF INSTALLATION "
~ 7<""i J ..;..7ti? A.N1J7tJrP1L, Cr,
1.
New Residential-Single or
Hulti-Family per dwelling unit.
Service Included:
A.
LEGAL DESCRIPTION
17lJ~ IS" 190
nlJ/)"(.
Items
Cost
Sum
$ 85.00
JOB DESCRIPTION
FU:e.;r~ ,aFffN'~--J'
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dwelling
Service or Feeder
Permits are non-transferable and expire
if work is not started within 180 days.
of issuance or if work is suspended for
'lBO days.
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY
Services or Feeders
Installation, Alterations or
Relocation:
B.
Electrical Contractor ~R~ etA::(.
Address Ro. ~ ;;L'7~5
Ci ty -E:z..k:. ~ Phone ~c:;; - ~~
Supervisor License Number ;? J... tf b.s
~~U),,(".. -:'~..:?'.r
Expiration Date u:i/:::r"
Constr Contr. Number <137,192-
Expiration Date/:;..j 2./ /,... J
r
$ 50.00
$ 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.
$ 40.00
$ 55.00
$ BO.OO
volts see "B"
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
S"l"~.~~:/i~El""l'l"
Owners Name -~~ /:.
above
Branch Circuits
D.
New, Alteration or Extension Per Panel
Address
~ $ 35.00 -J..S., G-<l
One Ci.rcui t
Each Add it i onal
Circuit or with Service
or Feeder Permit ~ $
City Phone 7-11 ~/ItJS'
OlINER INSTALLATION
2: 90 -6,&00
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 $ 36.00
5. ~/_~
SUBTOTAL OF ABOVE q-/_
5% State Surcharge + J?.. Z,DS" + /.1 ~
TOTAL 4.A, 2-~
, .1
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~ .:;it.'"5~
/ 4-~"" '":)
DATE:'
RECEIPT' jI.:
RECEIVED BY:'
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