HomeMy WebLinkAboutPermit Electrical 2001-09-244r\
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-225 FIFTH STREET APPTOVAI
SPRINGFIELD, OREGON 91 4IJNiNg
iNSPECTION REQIIE$T1"
'FFICE:
726'3759
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ELECTRICAI PERMIT APPLICATION
Number /) ( -Do 9}-l --af
I
A Ner.r' Residential-Single or
Multi-Familr' per du elhng unit.
Service Included:
Items Cost Sum
3. COMPLETE FEE SCHEDULE BELOW
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
60I amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
C. 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 volts see
"B" above
_ $106.00
$ 19.00 _
$ 50.00
_ $ 63.00 _
_ $ 75.00 _
_ $125.00 _
_ $163.00 _
_ $375.00 __ $ 5o.oo _
$s0.00
s69 00
$100 00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Permits are non-transferable and expire
if u,ork is not started within I80 days
of issuance or if work is suspended for
180 days.
Electrical
Address
Ciqv
Supen,isor Number l3Qc3-(
Expiratron Da.r- lO -Ol - Ol
Constr Contr. Number
Expirarion Da,r- q'(*'Ol
Signature of Supervising Electrician
Owners
Address \rL..&
cir-v--------Phondl-l=<-&--
O\\NER INSTALLATION
The installation is being made on
properfy I ovun which is not intended
for sale, lease or rent.
D. Branch Circuits
New, Alteration or Extension Per Panel
one Circuit J ,0, o, &"
Each Additional Circuit or with Service
or Feeder Permit $ 3.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
$50.00
Sigr/Outline Lighting-
-
$50.00
Limited Energy/Res
-
$25.00
Limited Energy/Comm $45.00
5. SI]BTOTAL OF ABOVE
'7o Stale Surcharge
8% Administrative Fee
,$
Ou ners Signature:
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TOTAL qq$s
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I LOCATION OF INSTALLATION
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