HomeMy WebLinkAboutPermit Electrical 1997-8-21
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'225 FIITH STREET THIg~~~1J THE WOR~LECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 91.wd~()~ID6'A THIS ~~S NOT '
INSPECTION REQUEST: CO~~8ED OR IS ABANo'ONED~fri-t-y. Job NumbeF q., J ;:;l S I
OFFICE: 726-3759 '
, . . ANY 180 DAY PERIOD: 0 3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION / 4J...-f .
~ l\i; '~i l\-(\ Q J _~)/~ New Residen tial-Single or
, .( t() Mul ti-Family per dwelling uni t.
LEGAL DESCRIPTION, Service Included:
, -
.
.
JOB DESCRIPTION -
;}J:)I} l.rMf . . l1~ru ~ ~~..J
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is s.uspended for
180 days,
2.' CONTRACTOR INSTALLATION ONLY
Electrical Contract?r.0.4'-" P~i1~)~,
AddressI 0, ~. JlH ~
"I '
Ci tY~Mln~to ~ ri, Phone '7 41-1.~36:..
Supervisor License Number llo g t-,S;
Expiration Date IO-I-,q g
Constr Contr. Number OJ\ZL/q
Expiration Date q-I-Q'1
. Signature of Supervising Electrician
a,.;'/L(/'-/~ . '
Owners Name....l..1.:,\~~~n~IY\O \
Address 1.on ~_hu1:.Y\lJY\'l~Q 1.J::t-.
Ci ty~ (Ut ,Phone '11),(".:. 4335
o~ INWALLATION .
1000 sq.ft. or less
Each additional 500
sq. ft or 'portion
thereof ,
. Each Manuf'd Home, or
Modular. 'QweHing
Service or Feeder
.B.
Services or ,Feeders
Install~iion, Alterations
or Relocation:
,
"
. ~. .."'"
Items
Cost
Sum
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 ,
$ 85.00
$ 15.00
$40.00
$ 50.00 '
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00 40.00
$ 55.00
$ 80.00
see II,B" above,
"
New, Alteration or Extension Per Panel
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL .
One Circui,t
Each Additional,
Circuit or with Service
or Feeder Permit'
$ 35.00
$ 2.00
not included)
E.' Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
The 'ins talla t ion is being, made on
property I own which is not intended
for sale. lease or rent. '
Owners Signature:
~A~E~-~~~-rttl~---------------------
RECEIPT '11: . O.,L.- II S q , .
RECEIVED By:illYL{,((jA{idrJ , '
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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