HomeMy WebLinkAboutPermit Electrical 1998-07-06225 FIFTB STREET
SPRTNGFTELD, OREGON 97 471
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One Circui t
Each Addi tional
Ci rcui t or vi th
or Feeder Permit
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INSPECTION REQUEST: 126-31fua*
OFFICE: 126-3159
1. LOCATION OF INSTALI-ATIONJT
LEGAL DESCRIPTION
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
E L e c t r i ca 1 Co n t ra c t o r Y-SEEifLt c fr," O Lrlr$o( toih
Add res s "o
Ctty C,- *Phone 6Pb:bZ3_L_
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ELECTRICAL PERHIT APPLICATION
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3. COHPLETE FEE SCffiDIJLE BELOV
Nev. Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
1-000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
s 8s.00
$ 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
Thelo[drlng ProFGt areubmncd !F9thoil*.* -;no -aa*tnol toqulte epecfrc tottd
A
Sum
DD
Supe rv i s or License Number ,o->9 q<-
Expir:ation Date lO'- l-q?
Constr Contr. Number 2OPPq
Expir:ation Date ly- \t 4?
Signature of Supervising Electrician
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0n1y
----T-
$ s0.00
s 60.00
s100.00
$130.00
s300.00s 40.00
Ovners
Add res s
Name
OI{NER INSTALLATION
The installation is being rnade on
property I ovn ruhich is not intended
for sale, Iease or rent.
0vners Signature:
DATE:
RECEI
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000-voEs
D. Branch Circui ts
Nev, Alteratj.on or Extension Per Panel
C
s 40.00
s ss.00
$ 80.00
see ,Btt a6ove
s5 ryD
Ci ty S(1,-thuxt Phone ltil> - 3{tf -+-
Se rvi ce
$ 3s.00
$ 2.00
no t j"ncluded )
40.00
40.00
20.00
E Miscelfaneous ( Service/feeder
-Each installation
Pump or irrigation $
Sign/outline Lightirg- $
Limited Energy/Res $
Limited Energy/Comm S
35
o
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTALRECETVED B
5l)
Sq-reu