HomeMy WebLinkAboutPermit Electrical 1996-5-23
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
,OFFICE: 726-3759
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JOB DESCRIPTIQN. f' 1000 sq.ft. or less
\..A"(\t:'\. (\\. 1 t ~~() ~ ~"\r\ ~~ach addi tional 500
~ ,- ,___. ~ ~sq. ft or portion
Permits are non-transferable and expire thereof
if vork is not started 'vi thin 180 days Each Malluf'd Home or
of issuance or if,vork is suspenoed for Modular Dvelling
180 days. 'Servi'ce or Feeder
, . - .'
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Z I 'L r--...n ELECTRICAL PERMIT APPLICATION
97477 onng l ) ~ . " f'\..n \
726-376gJoto 5!;;)3!Cfb City Job Number 4\0\ )\(M
AUlho~zed SIgnature3 :SQ..Q"...u "u" _<:.",',IEDULE BELOII
1. ~O.sJ\TION qz INSTALl4.~I9N T '
~"':)\o\ ,~\l\~ ~~Q51T A. Ne" Residential-Single or
, ," - Mul ti-Family, per d"elling uni t,
\~~m~IO n?/){)() Service Included: Items
2..' CONTRACTOR INSTAL~TION. ONLY ',_' B.
Electrical ContractQr'7\()X\\~,..\h"\0
Address\~i) . ~\tl\r'\'\ ~J\.\:rL
City Y 10lfr\Q...., Phonel1s:t. \~
supervis~r ~cense Number ctLt~
Expiration Date \TJ. \
Constr Contr. Number \ r2:>\?rJ
\ 'd,. ~'1.0f\
Expira tion Da te
Signature of Supervising Electrician
~~
O"ners ~am\' ~ f\f\'k ~ \),0 \:\-'
Address~ \ \'f). \ C\~% ,fV;, .
City,~ Phonel4;l.~,l)
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OIlNER rKSTALLATION
The installation is being made on
property I ovn "hich is not intended
for sale, lease or rent.
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Ovners Sirrnature:
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----------------------------~~71T------
DATE: VJ'L.J"'\~'
RECEIPT II: . \ -
RECEIVED BY: v.v'"
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
Cost
Sum
$ 85.00
$'15.00
? s 40.00" '~(:)
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
S 40.00,
$ 55.00' "
S 80.00
see "B" above
Ne", Alteration or Extension Per Panel
$ 35.00
S 2.00
2-..
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation S 40.00
Sign/Outline Lighting S 40.00
Limited Energy/Res S 20.00
Limited Energy/Comm S 36.00
5. SUBTOTAL OF ABOVE ~,()()
57. State Surcharge - -1\11
37. Administrative Fee '.'..o...lP
TOTAL -r, '-.'l
...-, .~~n
One Circuit
Each Addi t ional
Circuit or "ith Service
or Feeder Permit