HomeMy WebLinkAboutPermit Electrical 1996-01-30225 FIFTS STRXET
SPRINGFIELD, OREGON 97 477
fNSPECf,ION REQUEST. 726-3769
OFFICE: 726-3759
1. LOCATION OF ALI^ATION
SPFIFTGF tELO
Ci ty Job Number
3 COHPLETE FEE SCMDI.ILE BELOV
Nev Residential-Single or
Multi-FamilY Per dvelling unit'
Service fncluded:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
B Services or Feeders
lnstal1ation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs --401 amps to 600 amPs
-
601 amps to 1000 amps-
0ver 1000 amPs/vo1ts
-
Reconnect OnlY
C
s 2.00
IC\DE- ELECTRICAL PERHIT APPLICATION
,l2L A
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 INSTAII-ATION ONLY
Electrical Contractor
Address
Ci ty Phone
Supervisor License Number
Expiration Date-
Constr Contr. Number
Expiration Date
V Signature of Supervising Electrician
Ovners Name
Temporary Services or Feeders
lnslallaiion, Alteration or Relocation
Sum
s s0.00
s 60.00
s1oo.0o
s130.00
s300.00
s 40.00
200 amps"or less $ 40'00
201 amps to 400 amps
-
S 55'00
over 4b1 to 6oo amps -- S Bo.oo
Over 600 amps or 1000-voITs see "B"
4,a
above
Ci ty
OI'NER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Signature:
DATE:
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
s 3s.00
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAI,
E Miscellaneous (Service/feeder not included)
-Each installati.on
Pump or irrigation
-
Sign/Outl-ine Ligh t ing-
imited EnergY/Res
imited EnergY/Comm
Address /z s4 5/,
Ph","#S'/96y'
s 40.00
s 40.00
s 20.00
s 36.00
5
hfr^n7rmn D
&
LEGAI DESCRIPTIONtVi-^---ii-oa o, ;a: (Td)
JOB DESCRTPTIONw i'-- rm ;.f c