HomeMy WebLinkAboutPermit Electrical 1997-12-15SPRINGFIELD, OREGON' 97 d+77, : - .:: . : .,
inspsmroN REQUEST z 726-376'9
OFFICE: 726-3159
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EI,E.CTRICAL PERHIT APPLICATION
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city Job rt^u., 77/272225 FIFTE STREET
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1. LOCATI OF STALLATION
LEGAL DESCRIPTION
e-\
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALL\TION ONLY
Electrical Contractor
Add ress
Ci. ty Phone
Supervi s,:lr Li cense Number
COMPLETE FEE SCHEDIJLE BELO\I
Nev Residential-Single or
MuIti-FamilY Per dvelling unLt
Service Included:
I tems
3
A
Expir:ation Date
q.ft. or less
ddi tional 500
t or portion
of
anuf'd Home or
ar Dvelling
ce or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less /
201 amps to 400 amps
-401 amps to 600 amps _60L amps to 1000 amps_
0ver 1000 amps/vo1ts
Reconnect 0n1y
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
1000 s
Eacl-r a
sq. t
there
Each M
ModuI
Serv i
<,.
Cos t
$ 8s.00
$ 15.00
$ 40.00
s s0.00
s 60.00
$100. 00
$130. 00
$300.00s 40.00
not
40.
40.
tu.
36.
Sum
aEove
_z-"
B
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
0nners Name
Add ress 3t
Ci ty si & Phone s-f-t- qk/-)s?3
OTTNER TNSTALK\TION
The installation is being made onproperty I ovn vhich is not intendedfor sale, lease or rent.
0vner
DATE:Qt
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or iess $ 40.00
201 amps to 400 amps
-
S 55.00
over 401 to 600 amps
-
$ 80.00
0ver 600 amps or 1000-tofTs see "B"
/-\
, C.\
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional-
Circuit or vith Serviceor Feeder Permit g 2.00
Miscell-aneous (Service/feeder
-Each installation
Pump or irrigation $Sign/Outl-ine Lighting- $Limited Energy/Res
-
$Limited Energy/Comm $
included )
00
00
00
00
5 *O
RECEIVED BY:
ture:
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