HomeMy WebLinkAboutPermit Electrical 1992-08-07st,rttN(;FrI:Lo
Al
1
225 FIFTII STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUESTz 726-3769
0FFICE: 726-3759
0r
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. COI\ITRACTOR
Electrical Con
Add ress
Ci ty ?;;un O Phonea\--vSupervisor Li-cense Number ps\qq
Expiration Date
Constr Contr. Number
Expiration Date 5'
Signatu re of Supe rvising Blectrician
I
ers Name
ELECTRICAL PER}IIT APPLICATION
City Job Number qsl
COHPI.ATE FEE SCBEDULE BBLOS
Nev Residential-Sing1e or
HuIti-FamiIy per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
3
A
Sum
ON ONIY
0ver 1000 amps/volts
Reconnect On1y
Temporary Services or Feeders
Insta1lation, Alteration or Relocation
D. Branch Circuits
Nev, Alteration or Extension Per Pane}
$ 3s.00
B. Services or Feeders
Installation, Alterations or' Relocation:
Ir less Io 400 amps
o 600 amps _o 1000 amps_
c
One Circui t
Each Addi tional
Circuit or vith Service
or Feeder Permit
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/0ut1ine Lighting- $
Limi ted Energy/Res $
Limited Energy/Comm S
SUBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
200 amps or less $ 40.00
Over 401 to 600 amps _ S 80.00
0ver 600 amps or L000 volts see rrBrr above
tractor
#ll l2oo amps 5Do
t
t
t
201 amps
401 amps
601 amps
$ s0.00
$ 60.00
$100.00
$130.00
s300.00
$ 40.00
1^-Address
Ci ty Phone
OVNER TION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0nners Signature:
DATE:
E
5
$ 2.00
not included)
40.00
40.00
20. oo
RECEIVED BY:
@
C'fY OF
:;rrrtltY(;l:tr:LL)
eb
225 FIFTII STRBEf,
SPRTNGFTELD, oREGoN 97477
INSPEGII0N REQIESTT 726-3769
0FPICE: 726-3759
1 0r
PTI
Permits are non-transferable and expireif vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COIITRA TOR ONLY
Electrical Contracto
Address
ELECTRICAL PERHIT APPLICATIONq&i
A
Ci ty Job Number
3 COHPLETE PEE SCTIEDULE BELOS
Nev Residential-Single or
Multi-FamiIy per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Modular Dvelling
Service or lreeder
$ Bs.oo
$ 1s.00
$ 40.00
B Services or Feeders
Installation, Alterations or
ReIoca t ion:
Sum
.,,r-fltJCyn
#ll l2oo amps or
201 amps to
401 amps to
601 amps to
s
amps
amps
000 amps_
Over 1000 amps/volts
Reconnect Only
One Ci rcui t
Each Addi t ional
Ci rcui t or vi th Servi ce
or Feeder Permit
I
4
6
1
$ s0.00
$ 60.00
s100.00
$130.00
s300.00
$ 40.00
s 2.00
5O
O Phone
es,
00
00
Supervisor ,r\""r;-rrruu. 3R \q3
Expiration Date
Constr Contr. Number
Expiration Date 5'
Temporary Services or Feeders
Installation, Alteration or Relocation
D. Branch Circuits
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
Over 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see I'Brr above
c
Signa of Supervising Electrician
rs Name
Address
Ci ty Phone
OIJNER ALLATION
The installation is being made on
property f ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
+N-S Nev, Alteration or Extension Per Pane1
s 3s.00
ct
E. Hiscellaneous (Service/feeder not included)
-[ach installation
Pump or irrigation
Sign/0ut1ine Lighting-
Limi ted Energy/Res
Limi ted Energy/Comm
SUBTOTAL OF ABOVE
5X State Surcharge
TOTAL
$ 40.00
s 40.00
$ 20.00
s 36.00
DATE:
RECEI PT
RECBIVED BY
5
I
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