HomeMy WebLinkAboutPermit Electrical 1997-10-13CITV OFf*-
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ldr*225 FrFTE STREUT ,,'\ _.2 (,t
SPRTNGFTELD, oREGON 974'17', -\-Y-:-:4:--( t-
INSPECf,I0N REQUEST . 7 26;3.7,SS:j :j,i,i :;.,,:'-.
OFFICE: 726-3759
1 OP ON
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JOB DESSRIPTI
C v^1-
Permi ts are non- t rans erable and expire
if work is not started vithin 180 days
of issuance or if work is susperrded for
180 days.
2. CONIT.ACTOR INSTALI,ATION ONLY
Electri
Add res s
caI Contractor
0l//
Ci ty Phone
ILECTRICAL PERilIT APPLICATION
Ci ty Job Number 9tr ?q
COHPLtrTE FEE SCEEDULE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
$ is.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
(\ r",
3
A
Sun
t
B
-))be
s s0.00
$ 60.00
$100.00
s130.00
s300.00
$ 40.00
200 arnps or fess
201 anrir.s to 400 amps
-401 arnps to 600 amps _601 amps to 1000 amPs_
Over 1000 amps/voIts
-
Reconnect 0n1Y
Supervisor License Number
Expiration Date
Constr Contr. N
Expiration Date
Signa ture of Su pervi
Ternporary Servi ces or Feeders
InstalIat,ion, Alteration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
0ver 600 amps or 1000-voTts
C
umbe r
trician
$
$
$
se
40.00
55. 00
80.00
e ttBtt a mve-
D Branch Circui ts
Nev, Alteration or Extension Per PanelOvners
Address
Name
6
Ci ty hone
OVNER INSTALLATION
The instatlation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Onne tu
DATB:
RECEI
Miscellaneous (Service/feeder not included)
-Each ins tallation
Pump or irrigation $ 40.00
iieizorrline"Lighting- $ 40.oo .-
Liili ted nnergyzie. "Z $ zo. oo m-
One Circui t
Each Addi tional
Circui t or vi th
or Ieeder Permit
Service
SUB'IOTAL OT ABOVE
5Z State Surcharge
3% Admini.s trative Fee
TOTAL
E
5
$ 35.00
$ 2.00
-lT:-
RBCEIVED B
r)
The followin6 project as subn
zoning, and <Joes not roquiro
-'/'.
ALARI{'SrSTEl{ PBRI{rr - $40 FEE
CITY OF SPRINGFIELD
DEVELOPMENT SERVICES
225 PIFTH STREET
SPRINGTIELD 97 477
DATE:
IS THE ALARM SYSTEM BEING INSTALLED AT A RESIDENTIAL OR BUSINESS
LOCATION?
RESIDENTIAL BUSINESS
1
2
If a residentially installed systen,
1 through 6. If the systeo is being
location, please complete questions 7
Name:,
Addre
Ci ty:
?rt u
ss3 o
L(
please complete questions
installed at a business
13.
State i zip,1lV77
3. Phone Number:4. Date of Birth:
5. Is the system being lnstalled by the homeovner? Yes-No
It no, then indicate the company that vill be lnstalling the alarm
sy s tem:
Co
6. Date of installation:U
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7. Business name (only if system vas installed in business):
8. Owner Namer
9. 0vner date of birth:
10. Business address:
zip:
11. Phone Number:
12. Company that installed alarm system:
13. Date of installation:
ELECTRICAL PERMIT REQUIRED
Ci ty: State: